The NHS waiting list for routine operations has surged to record levels amid rising admissions of coronavirus patients, ‘calamitous’ figures reveal.
NHS England data published today shows 4.46million people were waiting for routine ops like joint replacements or cataract surgery in England by December.
Of them, almost 200,000 had been on the list for more than a year, the highest number since records began in 2007 and 140 times more than in 2019.
For comparison, there were a total of 4.42million patients on the waiting in 2019, and 4.45million the year before. There were just 1,398 people waiting a year or longer last year.
Separate figures, also published today by the NHS, showed critical care units were 40 per cent more full in the second week of January than last year. Almost 800 patients were forced to wait in ambulances for more than an hour in hospital car parks before being admitted to emergency wards.
Top medics said today’s figures paint a picture of the ‘calamitous impact’ of the pandemic on the health service and warned a ‘huge, hidden waiting list’ was building up during lockdown.
And the British Heart Foundation said they showed 12,000 fewer heart operations went ahead in November 2020 compared to previous years.
It comes amid mounting warnings that hospitals could be overwhelmed by admissions of Covid-19 patients, which spiralled in December and early January.
But in a glimmer of hope, figures released by the Government appear to suggest hospitalisations in London and the South East have peaked – in an early sign the second wave could be beginning to lose steam.
Total admissions remain high, however, with the University Hospitals Birmingham trust saying today it would suspend kidney transplants due to Covid admissions.
And data leaked today suggests one in ten hospital nurses are now off sick in the worst affected areas of the country, reports the Health Service Journal.
The total absence rate among acute trust nurses was 9.7 per cent as of Monday, up from around 7 per cent at the start of December. But it is unclear how many absences are linked to Covid.
The highest rate was in the East of England where 11.4 per cent of nurses were off work, with coronavirus accounting for 7.5 per cent.
NHS ASKS HOSPITALS IN ENGLAND TO OPEN HUNDREDS MORE INTENSIVE CARE BEDS
Hospitals across England are being told to open hundreds more intensive care beds so they can take in non-Covid patients from hotspot areas, it emerged today.
A letter sent by NHS England bosses to dozens of trusts has ordered them to open the emergency capacity by tomorrow in a bid to take pressure off the worst-hit hospitals to keep vital treatment up and running.
The letter, seen by the Health Service Journal, says transfers from the East and London will go to the largest Midlands trusts, who may be transferred to smaller trusts.
If the Midlands starts to become overwhelmed then it may be able to transfer patients to Yorkshire and the North East. Patients in the South East will be moved into the central south and South West.
Heath chiefs say the network approach is the most efficient way to share the burden and may keep travel distances shorter, meaning better safety for patients.
Most hospitals have beds that go unused because there are not enough staff to man them. Covid social distancing rules have meant that more beds than normal were not allowed to be used.
It comes as University Hospitals Birmingham Trust announced all kidney transplants had been paused and waiting lists suspended for two weeks to deal with Covid. The trust has had to redeploy hundreds of staff to the frontlines to man ICU wards amid the winter wave of Covid admissions.
Hospitals nationally are treating more Covid sufferers than they were in spring and NHS bosses have warned it will remain on the brink until at least February.
Reacting to the findings today, Dr Nick Scriven, former president of the Society for Acute Medicine, said: ‘This data shows exactly how dire things are with millions of people waiting to start hospital treatment and 330,000 people waiting more than six weeks for key diagnostic tests, so the effects of Covid-19 will been seen for years to come and the impact on many individuals could be irreparable.
‘But what is of particular note and concern for us in urgent care is that the attendances at emergency departments were higher than the peak in April and this data is well before the effects of the current wave will be seen – and this is against a backdrop of many hospitals being at capacity now.
‘So whether you look at the here and now or the future, the challenges are truly daunting.
Professor Neil Mortensen, president of the Royal College of Surgeons of England, said: ‘Today’s figures show the calamitous impact of Covid-19 on wait times for operations.
‘In November, a record number of patients were waiting for hospital treatment.
‘For thousands of people in this country, a corrective operation is the best way to relieve debilitating pain and get them back up on their feet, back to work and enjoying life again.
‘Many of us were complaining about the pain of the lockdown restrictions in November.
‘However, we should remember all those people waiting for an operation, who had their physical pain to deal with, on top of the pain of lockdown.’
The head of policy and public affairs at the charity Versus Arthritis, Tracey Loftis, warned delays to planned treatment could leave arthritis suffers facing debilitating pain or limited mobility for longer.
‘While it is understandable that operations are cancelled at this time, thousands of people are having to endure longer periods of pain,’ she said.
‘People waiting for joint replacement surgery urgently need clear communication about their care, and support including advice on pain management and mental health and well-being. This could be vital in helping people in real difficulty to try to maintain their health as they wait.’
NHS England data shows 27 per cent fewer patients were admitted for routine treatment during November 2020 compared to last year. Some 222,180 went ahead with their scheduled ops, down from the previous 303,193.
Some 4,385 patients were in critical care beds by the second week of January this year, over a thousand more patients than the 3,111 recorded in the same week last year.
It left around one in five major hospitals in England without any spare capacity in their critical wards on January 10.
Some 27 out of 140 reported 100 per cent occupancy of all ‘open’ beds at this time – the latest date for which statistics are available.
These included University Hospitals Birmingham NHS Foundation Trust, which had all 147 beds filled; Leeds Teaching Hospitals NHS Trust (all 75 beds); Brighton & Sussex University Hospitals NHS Trust (all 66 beds) and Lewisham & Greenwich NHS Trust in London (all 51 beds).
Ambulances also faced longer waiting times before discharging their patients.
NHS PERFORMED 12,000 FEWER HEART OPERATIONS IN NOVEMBER 2020 COMPARED TO PREVIOUS YEARS
At least 12,000 fewer heart operations were carried out in England in November 2020 compared to previous years, the British Heart Foundation has said.
NHS England figures show there were 25,000 heart operations – such as coronary bypass and heart valve surgery – by the end of November last year.
But as many as 37,000 were carried out in the same period the previous year.
Overall, BHF analysis says 96,000 fewer heart procedures had been carried out in the year to November 2020 compared to previous years.
Charity bosses at the BHF said the figures highlighted the ‘seismic impact’ of the pandemic upon potentially life-saving surgery for thousands of patients.
Dr Sonya Babu-Narayan, associate medical director at the charity, said: ‘The NHS is working on overdrive to prioritise all urgent Covid and non-Covid care.
‘At the same time, we must not lose sight of people with heart conditions whose planned treatment has been delayed.
‘Surgery and other invasive procedures to treat heart disease are not luxuries that people can easily go without -delaying them can cost lives.’
She added: ‘The significant backlog of people needing heart treatment will keep growing as Covid-19 cases soar. This may only be the tip of the iceberg as the true scale of the disruption to cardiovascular healthcare is still unknown.
‘The moment the crisis abates, we need to urgently address the backlog of people waiting for treatment before it becomes too late for some.
‘To do this, hospitals will inevitably need more and ongoing investment in heart and circulatory disease care.’
There were 788 waiting outside hospitals for more than an hour in the second week of January, compared to 600 the year before. In 2019 figures show 396 ambulances had to wait more than an hour, and in 2018 there were 374.
University Hospitals Birmingham NHS Foundation Trust had the highest number of patients waiting for at least 30 minutes (780), followed by London North West University Healthcare NHS Trust (372) and University Hospitals Leicester Trust (360).
In Accident and Emergency (A&E) a further 9,267 patients had to wait for between 30 and 60 minutes before being handed over to NHS staff at hospitals, the highest weekly figure so far.
Overall, nearly 15,000 patients waited at least half an hour to be transferred to hospitals in the week to January 10.
A&E department figures, however, showed a fall in the total number of admissions in December 2020, although it is not clear whether this was still the case by January.
They dropped 18 per cent in December 2020 after 460,260 total admissions, compared to 560,795 at the same time in the previous year.
Attendances also fell compared to a year ago. A total of 1.5 million attendances were recorded in December 2020, down 32 per cent from 2.2 million in December 2019.
NHS England said the fall is ‘likely to be a result of the Covid-19 response’ – suggesting that people are still staying away from A&E because of the pandemic.
Professor Powis, NHS national medical director, said: ‘The NHS has cared for nearly a quarter of a million covid-positive patients already, who collectively spent more than two million nights in hospital, while also keeping emergency care running.
‘These figures are a stark reminder that the NHS is facing an exceptionally tough challenge, and that while still millions of people are getting care for non-covid health problems in the NHS in England – indeed for every covid patient in hospital, the NHS is treating three people for other conditions.
‘There is no doubt that services will continue to be under additional pressure until and unless this virus is under control, which is why it’s so important that everyone practises social distancing and follows national guidance.’
Mr Ashworth, Labour’s Shadow Health and Social Care Secretary, said the figures showed the ‘alarming and sustained pressure the NHS has been under for months now – impacting all areas of treatment’.
‘Hospitals are struggling to deliver urgent care in the most difficult of circumstances, while over 190,000 people have now been waiting over a year for treatment.
‘Years of underfunding, bed cuts and understaffing left our NHS exposed when the Coronavirus epidemic hit us.
‘It is vital that we now have a Herculean effort to roll out at least two million vaccines a week, with NHS staff vaccinations completed in the next week, to ease pressure on our NHS.’
A spokesman for NHS England said that while the waiting list is bigger, the median waiting times for elective care – procedures that are planned in advance – has ‘dropped for the third month in a row’.
They added: ‘Twice as many elective treatments were delivered and three times as many diagnostic checks were carried out than in the first wave peak in April.
‘That’s despite us treating 20 per cent more Covid patients than in the April peak.’