The NHS has a “hidden waiting list” of 15.3 million patients who need follow-up appointments for health problems, according to the first analysis of its kind.
Kat Lay, Health Correspondent www.thetimes.co.uk
The official waiting list, which stands at 3.9 million, shows how many patients are yet to have their first hospital appointment after a GP referral.
However, the total number who are on hospital books in England and need appointments is not collated centrally. A new calculation, based on freedom of information requests to NHS trusts and seen by The Times, puts the figure at 15.3 million.
Although the official waiting list, after initial referral by a GP, has remained at a fairly stable level throughout the pandemic, this has been mainly driven by fewer patients joining it. Long waits have increased, however, with the number of patients waiting more than a year standing at 50,536 in June, compared with 1,643 in January, before the pandemic hit.
The new data, which has been calculated by the healthcare technology company Medefer, backs up reports of patients struggling to get vital appointments and further demonstrates the health toll that the coronavirus is taking.
The Times reported last Saturday that more than a hundred MPs had written to Boris Johnson urging him to tackle a backlog in NHS cancer care that threatens to lead to thousands of deaths over the next decade.
Bahman Nedjat-Shokouhi, the chief executive of Medefer, said: “The official waiting list is the tip of the iceberg.
“However, almost four times the number of patients need appointments, as the official figures capture only the new referrals and not the patients who require ongoing care. We need a plan to deal with both groups to avoid patients coming to harm.”
Dr Nedjat-Shokouhi, who is also an NHS consultant, said there was a risk that, as waiting time targets applied only to initial referrals from GPs, patients needing follow-up appointments might become less of a priority. He described them as “the most easy group to delay care for”.
There is no suggestion that all 15.3 million patients are overdue an appointment. However, thousands of people have had NHS care postponed or cancelled this year as the health service focused on the pandemic.
The 15.3 million figure was calculated by asking NHS trusts how many patients who needed a follow-up appointment, but were not captured in the official waiting lists known as the “referral to treatment” pathway, were on their waiting lists. One trust in seven replied, and analysts extrapolated the national figure by weighting those trusts’ figures according to the proportion of national GP referrals they received.
In recent guidance, NHS England suggested that hospitals could move to a model called “patient-initiated follow-up”, where instead of being given a specific date to return, people with certain conditions could book a new appointment when they felt that they needed it.
One NHS consultant told The Times that he was concerned this could mean that patients with serious symptoms, but who did not want to bother the NHS, could slip through the net.
Responding to the new analysis, Miriam Deakin, the director of policy and strategy at NHS Providers, said: “It’s certainly a concern that many treatments had to be delayed at the height of the pandemic, and trust leaders are keenly aware of how disruptive and distressing this has been for patients. We also know that some patients chose, for a variety of reasons, not to come forward to seek treatment or advice during lockdown in particular, and referrals to trusts have dropped for a number of conditions.
“Trusts and frontline staff are working flat out to restore and extend routine services, and we’re seeing encouraging signs that many are making good progress. It’s really important people seek help when they need it.”
Exemplifying the change in volume of treatment during the pandemic, a study being published today in the journal Open Heart shows that the number of NHS patients presenting to cardiology services at one hospital in Scotland more than halved during the lockdown, and the number of heart attacks diagnosed fell by 40 per cent.
An NHS spokesman said: “This flawed and self-serving analysis from an organisation trying to advertise its own services says nothing about whether or not the appointments it refers to are actually ‘overdue’.
“Now that hospitals have managed the first wave of coronavirus, treating more than 108,000 people for Covid-19, local health services are continuing to expand their services for routine care, alongside substantially enhanced capacity being contracted from the independent sector.