Hospital pressures

England’s NHS Waiting List Hits 5.6 Million

Few will be surprised to read that the number of people in England alone waiting to begin hospital treatment has risen again to a record high. 5.6 million people were waiting to start treatment at the end of July, an increase of almost half a million from the end of April. And the figure will not stop rising yet, with the Institute of Fiscal Studies estimating that the waiting list could reach 14 million by next autumn. The Guardian has more.

A total of 5.6 million people were waiting to start treatment at the end of July, according to figures from NHS England. This is the highest number since records began in August 2007 and includes those waiting for hip and knee replacements and cataract surgery.

The number of people having to wait more than 52 weeks to start treatment stood at 293,102 in July 2021, down from 304,803 in the previous month, but more than three times the number waiting a year earlier, in July 2020, which was 83,203. …

The data shows the total number of people admitted for routine treatment in hospitals in England in July 2021 was 259,642, up 82% from a year earlier (142,818), although this reflects lower-than-usual figures for July 2020, which were affected by the first wave of the Covid pandemic. The equivalent figure for July 2019, before the pandemic, was 314,280.

NHS England said many more tests and treatments had been delivered this summer compared with last, while hospitals cared for thousands more patients with Covid. It said there were 3.9 million diagnostic tests and 2.6 million patients started consultant-led treatment in June and July, compared with 2.7 million tests and 1.6 million treatments over the same time last year. …

NHS England also pointed to data showing that almost half a million people were checked for cancer in June and July, among the highest numbers on record. …

The new data showed that more than 325,000 patients in England had been waiting more than six weeks for a key diagnostic test in July. A total of 325,229 patients were waiting for one of 15 standard tests, including an MRI scan, non-obstetric ultrasound or gastroscopy.

The equivalent number waiting for more than six weeks in July 2020 was 489,797, while pre-pandemic in July 2019 there were 37,206.

Tim Mitchell, the Vice-President of the Royal College of Surgeons, said the overall data showed 7,980 patients waiting more than two years for treatment. The longest waits were for trauma and orthopaedic treatment such as hip and knee replacements, followed by general surgery such as gallbladder removals and hernia operations.

Worth reading in full.

NHS Waiting List Could Hit 14 Million in England by Next Autumn, According to IFS Report

A new report by the Institute of Fiscal Studies (IFS) says that the NHS waiting list in England could reach 14 million by next autumn and could then continue to increase “as the number joining the waiting list exceeds the number being treated”. And this, according to the author of the report, is just the beginning: “Much longer waiting lists [could] be with us for years to come.” Sky News has the story.

Currently, the number of people waiting to start routine hospital treatment is at a record high – 5.3 million, according to latest figures.

But the IFS has warned in its new report that there is a massive backlog of people still to come forward for treatment, largely caused by Covid [what about lockdown?].

Health Secretary Sajid Javid said the number of people on waiting lists could rise to 13 million in the coming months, but the IFS projects that the total could eventually surpass the Health Secretary’s figure.

“In our first scenario, 80% of the approximately seven million ‘missing’ patients return over the next year, the NHS operates at 90% of its 2019 capacity this year and next, and then at 100% capacity from 2023 onwards,” it says.

“Under this scenario, waiting lists would soar to 14 million by the autumn of 2022 and then continue to climb, as the number joining the waiting list exceeds the number being treated.”

The IFS said while it is unlikely all patients will return due to the fact some will have died and others might have had private treatment, most will probably require treatment at some point soon, especially as virus cases decrease and “people are more willing to seek health care”.

Max Warner, the author of the analysis, said: “There is a real risk that if the NHS cannot find effective ways to boost its capacity – a challenge at the best of times, let alone after a major pandemic – then much longer waiting lists will be with us for years to come.”

Worth reading in full.

England’s NHS Waiting List Hits Five Million for the First Time

In striving to “protect the NHS”, we have instead placed it under record levels of pressure. The number of people waiting to start hospital treatment in England alone continues to rise and has passed five million for the first time. The number waiting for more than a year remains significantly higher than before Covid – and lockdowns – began. The number of people who actually require treatment will be higher still since many are expected to be living with undiagnosed diseases, such as breast cancer, having been reluctant to burden the health service with check-ups during the pandemic. The Guardian has more.

NHS England’s latest set of monthly performance figures, published on Thursday, show that the waiting list stood at 5,122,017 in April – up 171,720 in a month.

The total has risen from the 4.95 million who were on it in March, which was itself almost 252,000 up on the 4.698 million recorded in February – a month-on-month rise of 5.4%.

The number of people being forced to wait at least a year for treatment in hospital, especially surgery, has fallen for the first time in over a year but remains a serious problem. Thursday’s figures also show that 385,490 people have now been waiting more than 52 weeks, 50,637 down on the 436,127 who were in that position last month.

Such long waits are a new phenomenon. In contrast, in March last year – before Covid triggered a suspension of much NHS care – just 3,097 patients had faced such an unusually long delay.

Ministers, NHS chiefs, medical groups and health charities are worried that growing numbers of patients are facing lengthening waits for vital care including cancer treatment, a hip or knee replacement, heart operations and surgery to remove cataracts to improve eyesight.

Worth reading in full.

Stop Press: Professor Karol Sikora, on Lucy Johnston’s “Sketch notes on a pandemic” podcast, says: “I’ve been working in oncology for nearly 50 years and I’ve never seen a crisis like this before.”

Hospital Admissions For Covid Continue to Fall in Scariant “Hotspot” Bolton

The number of people being admitted to hospital to be treated for Covid continues to fall in the former Indian Delta variant “hotspot” Bolton. The MailOnline has the story.

[The] latest NHS figures show there were 42 people in hospital in the Royal Bolton Hospital with the virus on June 1st, last Tuesday, down from 49 at the peak of the new variant scare a week earlier.

The number of people being admitted to hospital each day has tumbled, too, to just three on May 30 compared to 14 five days before. The numbers are trailing a decline in cases which appears to show a spike in new variant cases has come under control.

The same pattern is hopefully beginning to unfold in neighbouring Blackburn, the U.K.’s current hotspot which has also been hit by the Indian “Delta” strain, where infection numbers among over-60s have started to fall following a rise.

Although the borough’s infection rate was still rising at the end of May, a decline in infections among older people should help officials to keep hospital admissions and deaths under control.

More than 12,000 cases of the B.1.617.2 variant have been spotted so far in the U.K. and Public Health England last week admitted for the first time that it has become the most common variant in Britain. Almost one in five officially recorded cases – 2,149 – have been in Bolton, with another 724 in Blackburn with Darwen.

But the fact that Bolton has turned the tide of the super-infectious strain suggests it can be successfully controlled without lockdowns, instead using testing, contact tracing and vaccinations.

Covid hospital admissions started rising in Bolton in the first week of May around 10 days after cases began to rise – it can take several weeks for infected patients to become ill enough to need medical care…

Its coronavirus infection rate spiked 10-fold from just 44 cases per 100,000 people in the week ending April 22nd to a peak of 453 per 100,000 a month later on May 21st.

Cases have been most common in under-55s, who are least likely to have had two doses of a vaccine, but hospital admissions rose in the wake of the rocketing cases. Only a small fraction of patients had been fully vaccinated.

Health Secretary Matt Hancock last week admitted the link between infections and hospital admissions, which vaccines should separate, has so far been “broken but not completely severed”.

Worth reading in full.

Stop Press: According to the Prime Minister’s spokesman, quoted in the Guardian, “[it] still remains that there is nothing in the data currently to suggest step four [of the lockdown roadmap] can’t go ahead at the earliest date”.

But we do need to look very closely at the data over this coming week, which will be crucial to decide and really to get a sense of the data, particularly on hospitalisations and whether or not the excellent vaccine rollout programme has sufficiently severed that link between the increase in cases, which we always expected to happen, particularly after step three, and that subsequently leading to hospitalisations and deaths.

Worth reading in full.

People in England Waiting to Start Hospital Treatment Hits Record High

The number of people waiting to receive hospital treatment continues to rise, with 4.7 million people stuck on a waiting list by the end of February in England. This is the highest number since 2007, highlighting the impact of a year in which the NHS focused on Covid patients at the expense of many others. BBC News has the story.

Around 4.7 million people were waiting for routine operations and procedures in England in February – the most since 2007, NHS England figures show.

Nearly 388,000 people were waiting more than a year for non-urgent surgery compared with just 1,600 before the pandemic began.

During January and February, the pressure on hospitals caused by Covid was particularly acute.

NHS England said two million operations took place despite the winter peak.

However surgeons said hospitals were still under huge pressure due to the second wave of Covid, which had led to “a year of uncertainty, pain and isolation” for patients waiting for planned treatment.

Tim Mitchell, Vice-President of the Royal College of Surgeons of England, has asked how much longer those whose treatments have been delayed can be expected to wait.

Although the most urgent operations for cancer and life-threatening conditions went ahead, hundreds of thousands of patients waiting for routine surgery such as hip and knee operations, cochlear implants and vascular operations had their treatment cancelled or postponed.

People have been patient as they’ve seen the battering the pandemic has given the NHS, but how much longer can they be expected to wait?

This news again highlights the importance of Professor Karol Sikora’s oft-repeated, yet consistently ignored proposal for a Government press conference to be held which is entirely dedicated to non-Covid related illnesses.

Worth reading in full.

Cancer Deaths Likely to Rise for First Time in Decades Due to Covid Backlog, Charities Warn

A coalition of 47 cancer charities has warned the Government that cancer deaths will rise for the first time in decades unless the Covid backlog is addressed. MailOnline has the story.

Cancer deaths will rise for the first time in decades unless urgent action is taken to tackle the Covid backlog, the Government was warned today.  

One Cancer Voice, a coalition of 47 cancer charities, argued more money and staff are desperately needed to address problems stemming from the pandemic.

The charities – speaking collectively for the first time – also asked for the NHS to be given greater access to private facilities.

They said almost 45,000 UK patients “living with cancer without knowing it” should have started treatment in 2020 but did not due to delays caused by coronavirus.

Cancer experts today praised the charities for raising awareness of “the biggest crisis in oncology” seen in more than 50 years.

Official data released last week showed cancer waiting times have spiked during the pandemic because hospital staff and surgeries have been preoccupied with coronavirus patients.

The proportion of suspected patients seen by a specialist within the two-week target hit a record-low of 83% in January, NHS England said. 

It means nearly 30,000 people with suspected cancer waited more than a fortnight to find out whether or not they had the disease in January. Early treatment and diagnosis is crucial in preventing the disease spreading and becoming deadly. 

And the pandemic has led to an increase in the proportion of patients waiting more than a month to start crucial cancer treatment after their diagnosis.

Figures from NHS England last week revealed that cancer is not the only disease to have been neglected because of the focus on Covid. Altogether, some 4.59 million people were waiting to begin treatment at the end of January – the highest since records began in August 2007.

Worth reading in full.

Government’s Long, Slow Walk to Freedom is Costing Billions and Makes No Sense

This afternoon’s No 10 Press Conference

Today Boris Johnson held a press conference to mark what he described as an “emotional” moment in the lifting of lockdown as children return to school. Encouragingly, he said that the “greater risk now is keeping them out of school for a day longer”. 

Deputy Chief Medical Officer Dr Jenny Harries told the press conference that she didn’t expect schools to be forced to close again.

Less welcome was that she said it would take some families time to get used to the wearing of masks and regular testing, as though this was to be part of an ongoing normality.

On the plus side, she said the vaccination programme meant the R number was no longer so important.

The whole issue about vaccination of course is we have now protected the most vulnerable individuals as we come down the age groups into those with underlying health conditions. And so the impact on our hospitals going forward is likely to be significantly less.

She noted that cases, hospital admissions and deaths continue to fall, and that infections are now below 100 per 100,000 of population in every part of the country and are back to where they were in September.

She then reverted to alarmist nonsense, saying: “This is a level at which a new wave could easily take off from again”, and there is still “substantial strain” on the NHS.

In other words, everything’s going down – but don’t think that means you can resume your liberties, as it could reverse at any moment. On that logic, we’ll never be free.

As for the NHS being under “substantial strain” – Covid patient levels are back to where they were in October, when hospitals were running at normal levels, and dropping quickly.