NHS England waiting list hits record high as 7.6m on hold for routine treatment

The number of people in England waiting to start routine hospital treatment has hit a record high.

An estimated 7.68 million people were waiting to start treatment at the end of July, up from 7.57 million in June.

It is the highest number since records began in August 2007 and marks the eighth consecutive month of increases.

It comes as the government said the NHS will receive an extra £200m this winter.

Figures also showed a total of 389,952 people in England had been waiting more than a year – and around 7,289 people more than 18 months – to start routine hospital treatment at the end of July.

This is up from 383,083 – and 7,177 – at the end of June, respectively.

The government and NHS England set the ambition of eliminating all waits of more than 18 months by April this year, excluding exceptionally complex cases or patients who choose to wait longer – and all waits of more than a year by March 2025.

Cancer waiting times

Around 263,696 urgent cancer referrals were made by GPs in England in July, up 1% on 261,006 in June and up 10% year-on-year from 239,739 in July 2022.

The proportion of cancer patients who saw a specialist within two weeks of being referred fell from 80.5% in June to 77.5% in July – below the target of 93%, which is being dropped from October.

There was some improvement for cancer waiting times. In July, 37% of those starting treatment received their urgent referral more than two months prior, down from 41% in June and from 38% in July 2022.

That is down significantly from the worst-ever performance of 45% in January, though still significantly above pre-pandemic levels (21% in August 2019).

Meanwhile, 74.1% of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days, up from 73.5% the previous month. The target is 75%.

Ambulance response times

Further data revealed it took ambulances an average of 31.5 minutes to respond to Category 2 incidents – such as heart attacks and strokes – in August.

This was a slight improvement compared to July (31.8 minutes) and a big improvement compared to August 2022 (42.6 minutes).

However, it is still significantly worse than before the pandemic. In Aug 2019, the equivalent response time was just 21.3 minutes, and in Aug 2018 it was 20.6 minutes.

A&E performance

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 28,859 in August, up 21% from 23,934 in July.

The figure hit a record 54,573 in December 2022.

The number waiting at least four hours from the decision to admit to admission also went up, from 109,515 in July to 120,120 in August, an increase of 10%.

Analysis: Unless pay disputes are resolved – NHS waiting lists will keep rising

There are gains that will give much encouragement to health leaders: more urgent GP referrals (263,696) for cancer than any other July. And a slight improvement for ambulance waiting times in August when it took crews an average of 31.5 minutes to respond to Category 2 incidents (e.g. heart attacks and strokes).

That’s a slight improvement compared to July (31.8 minutes) and a big improvement compared to August 2022.

There has been a slight fall in the longest waiting times too. The number of people enduring waits of more than two years has fallen slightly, from 314 to 277.

And all of this against the backdrop of the busiest summer on record for the NHS in England with higher seasonal A&E attendances than ever before.

But it’s not all good news. The number on the list who have been waiting more than 18 months (72 weeks) has risen slightly, from 7,177 to 7,289. And the total number waiting more than 18 weeks is up from 3.09 million to 3.18 million.

And the headline figure that will dominate coverage is the record 7.68 million waiting for elective care. This figure has never been higher.

The prime minister will say his key pledge to bring down this waiting list is being undermined by strikes. And to some extent he is right.

More than 800,000 people have seen their routine care delayed because of eight months of strikes.

The nurses dispute has been resolved but junior doctors and their consultant colleagues will continue their strikes possibly long into winter. And for the first time they will strike together next week.

That will effectively bring the NHS to a grinding halt.

Unless this dispute is resolved the numbers will keep rising.

Prime Minister Rishi Sunak has made cutting waiting lists one of his priorities for 2023, pledging in January that “lists will fall and people will get the care they need more quickly”.

Shadow health secretary Wes Streeting MP said: “Record numbers of patients are waiting for healthcare and they are left waiting unacceptably long, whether it’s for an operation, ambulance, or in A&E. For millions of patients across England, the NHS is no longer there for them when they need it.”

Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: “Today’s figures show that despite ongoing pressures across the NHS, including record demand for emergency care this summer, and an increase in COVID cases during July and August, NHS staff are continuing to deliver for patients.

“Category 2 ambulance response times are more than 10 minutes faster than a year ago, and significant progress continues to be made to bring down the longest waits for elective care despite months of disruption from industrial action.”