How sick is the NHS crisis making you?

Labour has promised a “serious reduction” in the number of people on waiting lists within five years if they are elected by ramping up weekend hospital appointments to cut the backlog. They want to cut maximum waiting times for operations down to 18 weeks by the end of a first term.

The data is grim. NHS waiting lists are growing every months and doctors fear the long wait for treatment is making people more sick.

But what impact is this having on our health? Hannah Fearn takes a look

How long is the NHS waiting list? More patients than ever before are waiting for NHS treatment. The latest data on waiting list backlogs, recorded by the British Medical Association found that there were 7.77 million people on a waiting list for consultant-led care in England in September 2023. That includes approximately 6.5 million people, with some waiting for support for more than one condition.

How long are people waiting? BMA data shows that around half of patients (391,000 people) have been waiting more than a year for treatment - which is 254 times as many waiting 12 months or more than in September 2019, before the coronavirus pandemic.

What about for serious conditions? Cancer assessment waiting times are increasing, too. Of those referred urgently, 69.7 per cent of people were diagnosed or had cancer ruled out within 28 days in September this year. The national target is 75 per cent and has not been met since it was introduced two years ago. Before that date patients could be expected to be seen by a specialist in two weeks.

Sounds bad It is, but it's actually worse than that. There's also the "hidden backlog" - these are patients who require care but have either not yet presented, or who have had referrals cancelled. Some people are not referred urgently by their GP despite potentially serious symptoms, for example women experiencing heavy bleeding. These people may need consultant care but do not appear within the waiting list data.

How many of them are there? It could be millions. A study by Healthwatch which polled patients in autumn 2022 found that one in five patients attended four or more GP appointments before getting a referral and one in three referrals were never progressed due to administrative or other issues. The British Medical Association says GPs are finding it harder to make referrals.

Are sick rates rising? Sickness absence from work dropped rapidly in the two decades before the pandemic, but is now rising sharply along with NHS waiting lists. According to the Office for National Statistics, the percentage of working hours lost due to sickness or injury rose to 2.6 per cent in 2022, the highest it has been since 2004.

What about disability benefits overall? They’re going up too. There were 4 million people either claiming a personal independence payment or disability living allowance at the end of August 2022, according to DWP figures. That’s an increase of 310,000 in a year. And benefit payments for people supporting those with ill health is alongside, with 1.3 million people claiming a carer’s allowance in 2022, 1.5 per cent higher than the year before.

So wait times are making us sicker? Yes, according to doctors. Professor Kamila Hawthorne, chair of the Royal College of GPs, said delays left people waiting for support with serious conditions such as heart problems, hip or knee replacements or potential cancer symptoms - often getting worse in the process. “Patients getting sicker while they are on the waiting list is something GPs see and worry about, because the risk to the patient is so much greater. It’s inevitable that some people stuck will get sicker, because that’s the nature of illness,” she said.

What happens then? They often turn up to A&E, where long queues to be seen also cause complications. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said elderly patients in A&E are now waiting so long for emergency care that they are developing bedsores and delirium.

Are NHS managers aware of this? According to health policy analyst Richard Vize, even before the pandemic the House of Commons’ public accounts committee was concerned that the national health bodies “lacked curiosity about the harm caused to patients by delays, including pain, anxiety and deterioration”. “Waiting for treatment can lead to patients requiring more complex and expensive care and may limit their ability to work or carry out everyday tasks,” Vize told Yahoo News UK.

Is waiting affecting mental health too? Catastrophically. Figures held by NHS England show that two-thirds of people with a long-term physical health condition also have a mental health problem, such as anxiety or depression. As sickness rates rise, so too do mental ill-health rates, making people sicker. Figures held by the Department for Work and Pensions (DWP) reveal that mental health issues are now behind almost half (44 per cent) of working age disability benefit claims.

So that’s another waiting list to join? Sadly, yes. According to a study carried out by the Royal College of Psychiatrists in 2022, almost a quarter (23 per cent) of mental health patients wait more than 12 weeks to start treatment. More than two fifths of those with long waits between referral and second appointment had experienced a worsening of their mental health. If you include those in hidden waiting lists - those still waiting for a first referral from a GP - around three quarters had ended up seeking help from the emergency services in a mental health crisis.