NHS England has reported that NHS staff continue to make progress on ambitious catch-up plans, with elective waiting lists for 18 weeks and 18 months reducing in October. Tens of thousands more people received the diagnostic tests and checks they needed in October, with over 63,000 more compared to the previous month (2,055,449 in October – up from 1,992,370 in September.)
The latest monthly performance statistics show there were 81,655 category 1 incidents in November – the most serious ambulance callouts – the highest November total on record. Despite the increased demand, ambulance wait times across all types of call improved in November compared to the previous month. Alongside this, staff working in A&E dealt with more attendances, 2,166,710, than any previous November on record. The latest weekly winter update also shows there were an average of 712 patients a day occupying beds in hospital with flu last week – up from 482 cases the previous week and compared to 31 patients per day in the same week of December 2021.
The NHS continues to see the post-pandemic impact of viruses circulating again with adult norovirus cases also increasing – up almost 90% on the same time last year, with 318 beds closed each day last week (up from 169 in the same week last year). The number of paediatric beds closed and occupied due to RSV is five times higher than the same week last year, with an average of 132 each day (compared with 22 last year).
Hospitals and local areas continue to contend with issues in discharging patients who are medically fit from hospital, with data showing an average of 13,358 patients who were ready to leave remaining in hospital each day last week. Overall general and acute adult bed occupancy rates remain high for this time of year at 95.4% last week – compared to 93.8% at the beginning of December last year.
National Clinical Director for Urgent and Emergency Care, Professor Julian Redhead, said: “Despite the ongoing pressures on services which are exacerbated by flu hospitalisations, issues in social care meaning we cannot discharge patients who are ready, and record numbers needing A&E, staff have powered through to bring down some of our longest waits for care.
“We have already said we are dealing with a perfect storm of pressures this winter, including increased demand for emergency are, and today announced an expansion of mental health crisis services which will ensure people suffering a mental health crisis get the help they need as quickly as possible, and reduce the chances of a patient needing to go to A&E.
“That is all on top of the measures announced NHS’ winter plan published in October which includes new hubs dedicated to respiratory infections and a falls response service to free up ambulance capacity.
“But the public can also play its part by using the best services for their care – using 111 services for urgent medical advice and 999 in an emergency – and to come forward for vaccinations, if eligible, to protect you and others around you against serious illness.”
Cancer waits have also improved as the NHS continues to refer patients in record numbers as part of Long Term Plan commitments to catch three-quarters of cancers at stages one and two by 2028. The latest figures show the highest number of checks following a GP urgent referral for any October, with 239,180 people checked.
The NHS has announced more than 40 healthcare ‘traffic control centres’ are now live. Each of the 42 integrated care systems in England now having a dedicated 24/7 operation where teams, including senior clinicians, can use data and local insights to make considered decisions in the face of ongoing pressures.
While the increase in invasive Strep A infections remains low, following the increase in the number of children presenting, NHS leaders have written to local health areas to consider setting up Acute Respiratory Infection hubs to enhance same day access to specialist advice and care.
The Royal College of Surgeons of England warned that a ‘very difficult’ winter lies ahead in the NHS, with a record 7.21 million people waiting for planned care. While the statistics show progress has been made on reducing the longest waits, the next target set out in the Government’s Elective Recovery Plan is to eliminate waits of 18 months or more by April 2023. The RCS says that the latest figures show "slow progress" towards this target. They commented that, although there was a small reduction in the number of people waiting 18 months or more, the 18-month waiting figure has been "stubbornly stuck at above 50,000 patients for the past few months".
Meanwhile the total waiting list, and the number of people waiting a year or more for planned care continues to rise. In October 2022, 410,983 patients were waiting a year or more for planned hospital treatment. This is 98,318 more than a year ago; in October 2021, 312,665 patients were waiting 52 weeks or more.
The Government has announced that it will be setting up a new ‘Elective Recovery Taskforce’, to try to reduce waiting times for NHS patients by using additional capacity in the independent sector. The taskforce is looking at how collaboration between the NHS and independent sector can be improved, so that the NHS can make more use of independent sector capacity.
Mr Tim Mitchell, a consultant Ear, Nose and Throat Surgeon, and Vice President of the Royal College of Surgeons of England, said: “We are concerned that a very difficult winter lies ahead, with hospitals full of patients, flu and Covid-19, and increased pressure on emergency departments. We also face the prospect of industrial action by staff who are burnt-out and feel undervalued. Today’s figures show that yet again the total number of patients on the waiting list continues to increase. We are also worried about those patients who have been waiting a long time for planned treatment, with their lives effectively put on hold.
“We welcome the Government’s plans to help the NHS make use of capacity in the independent sector to reduce waits for NHS patients. However, it’s the same depleted workforce who will be treating patients there. The Government urgently needs to publish its workforce strategy. It can tinker around the edges of the NHS, but if we do not have enough staff to meet patient demand, existing vacancies will only get worse, putting remaining staff under more pressure.
“In surgery, the reality is that, without more nurses and anaesthetic staff to support surgeons in theatre, we will struggle to bring record waiting lists down this winter and beyond.”