NHS fails to hit key targets despite drop in waiting list

New data from NHS England shows 7.61 million treatments were waiting to be carried out at the end of November, relating to 6.39 million patients, down from 7.71 million treatments and 6.44 million patients at the end of October.

This is the second month the waiting list has fallen and relates to the period before the latest round of junior doctor strikes.

But 11,168 people in England were waiting more than 18 months to start routine hospital treatment at the end of November, up from 10,506 at the end of October.

The Government and NHS England set the ambition of eliminating all waits of more than 18 months by April 2023, excluding exceptionally complex cases or patients who chose to wait longer.

A&E waits also worsened, with 69.4% of patients in England seen within four hours in A&Es in December, down from 69.7% in November and against a target set for March this year of 76%.

The record low of 65.2% was recorded in December 2022.

The number of people waiting more than 12 hours in A&E departments in England from a decision to admit to actually being admitted was 44,045 in December, up from 42,854 in November, although still an improvement on last year.

The number waiting at least four hours from the decision to admit to admission rose from 146,272 in November to 148,282 in December.

Cancer targets were still being missed, the data showed, with 71.9% of patients urgently referred for suspected cancer in November 2023 being diagnosed or having cancer ruled out within 28 days.

This was up from 71.1% the previous month but below the target of 75%.

In addition, the proportion of patients in England waiting longer than 62 days in November from an urgent suspected cancer referral or consultant upgrade to their first definitive treatment for cancer was 65.2%.

This was up from 63.1% in October but well below the 85% target.

But a total of 269,631 urgent cancer referrals were made by GPs in England in November, up slightly from 269,492 in October, and also up year-on-year from 264,785 in November 2022.

Elsewhere, nearly one in three patients (31%) arriving by ambulance at hospitals in England last week waited more than 30 minutes to be handed over to A&E teams.

This figure was up from 29% in the previous week, but was not the highest so far this winter, which was 34% in the week ending December 10.

Ambulance response times also worsened in December, the data showed.

Calls dealing with the most urgent incidents, defined as calls from people with life-threatening illnesses or injuries, had an average response time of eight minutes and 44 seconds.

This was up from eight minutes and 32 seconds in November and was above the target standard response time of seven minutes.

Ambulances also took an average of 45 minutes and 57 seconds last month to respond to emergency calls such as heart attacks, strokes and sepsis.

This was up from 38 minutes and 30 seconds in November, while the target was 18 minutes.

Response times for urgent calls, such as late stages of labour, non-severe burns and diabetes, averaged two hours, 37 minutes and five seconds in December, up from two hours, 16 minutes and 47 seconds in November.

Sarah Woolnough, chief executive of the King’s Fund, said: “These figures show that the NHS is still not meeting the majority of its most important performance targets this winter.

“On some measures the situation is better than this time last year, in part thanks to efforts to increase capacity as well as relatively low hospital admissions from Covid-19 and flu, but patients are still not receiving an acceptable level of service.

“Behind each of these figures is a person who is struggling to receive the timely care they need and deserve, despite the best efforts of staff.

“During this challenging winter period, the NHS is prioritising access to the most critical urgent and emergency care services.

“But pressures are widespread across the health and care system, including ongoing industrial action over NHS staff pay and working conditions impacting the speed of elective recovery.

“With the waiting list for routine care at 7.6 million, it is increasingly unlikely that the Prime Minister’s pledge to improve waiting-list performance by this March will be met.”

She said to “end this cycle of poor performance, the Government must make long-term decisions to put the service back on track year-round”.

She added: “This includes making health and care a more attractive place to build a career, bolstering out-of-hospital care such as primary, community and social care services, and helping people live healthier lives through a focus on preventing ill health.”

Kate Seymour, head of advocacy at Macmillan Cancer Support, said: “Even though today’s data shows a slight improvement in waiting times, there are still thousands of people in England facing agonising delays for vital cancer diagnosis and treatment and what’s worse, this isn’t a new problem, we’ve been seeing it for years.

“Every day at Macmillan we hear how these unacceptable delays can cause needless anxiety and even result in a worse prognosis. People’s lives are being put at risk and it’s simply not good enough.”

NHS England said progress in the overall waiting list was due to NHS staff delivering more than 1.63 million treatments in November, the highest monthly activity on record and around 150,000 more than the same month before the pandemic.

The number waiting over a year for treatment also fell to 355,412 in November, the lowest it has been since May 2022, it said.

Furthermore, more than 2.3 million patients received diagnostic tests or checks – up 15% on the same month pre-pandemic with two million seen in November 2019, it added.

Health and Social Care Secretary Victoria Atkins said: “November was the first month without industrial action for over a year and we reduced the total waiting list by more than 95,000 – the biggest decrease since December 2010, outside of the pandemic.

“This shows the progress our fantastic NHS staff can make towards bringing waiting lists down when they don’t have to contend with industrial action.

“We want to put an end to damaging strikes once and for all, and if the BMA Junior Doctors Committee can demonstrate they have reasonable expectations, I will still sit down with them.”