500,000 wait for ear, nose and throat treatment after PM has NHS operation

The number of people in England waiting for ear, nose or throat treatment has risen sharply during the pandemic, with more than 37,000 waiting more than a year, analysis shows, days after Boris Johnson had a sinus operation on the NHS.

In total, 510,000 people are waiting for ENT operations, procedures or medical consultations on the health service, compared with 312,000 in March 2020, according to the review of NHS figures carried out by the Nuffield Trust for the Guardian.

Year-long ENT waits have risen even more sharply, the analysis shows. In March 2020, 258 patients had been waiting more than 52 weeks. By April 2022, the most recent month for which figures are available, the figure had risen by 14,000% to 37,548 patients, and 1,730 have now been waiting more than two years.

Downing Street has so far declined to confirm whether Johnson skipped the NHS waiting lists to have his operation on Monday morning. His spokesperson said they would not give any more detail in response to questioning over whether he got preferential treatment.

On Wednesday, after speculation about whether Johnson received priority treatment, the Daily Mail columnist Sarah Vine wrote: “I should jolly well hope so. He’s the PM … Whatever you think of how he may be handling things, we need him fit and well.”

Johnson’s spokesperson confirmed that the operation took place on the NHS, and would only say it had been scheduled “for a while”. Whatever the circumstances, his surgery has refocused attention on the colossal number of people waiting for NHS treatment, which has swelled to a record high of 6.5 million.

The analysis sheds fresh light on the plight of patients waiting for ENT operations. In London, where the prime minister underwent surgery after 6am on Monday at Guy’s and St Thomas’ NHS foundation trust, more than 72,000 people are waiting for ENT operations or medical care. Of those, 3,444 have been waiting more than a year.

“The pandemic has driven up waiting times for this specialism dramatically, with the waiting list growing by nearly two-thirds (63%), second only to waits for gynaecology (79%),” said Jessica Morris, a Nuffield Trust fellow. “Patients waiting for ear, nose and throat services are also experiencing some of the longest waits for care, with over 37,000 patients waiting over a year in discomfort for medical or surgical treatment.”

The Midlands has the worst wait times for ENT care in England, the analysis shows, with patients waiting on average 19 weeks. About 109,000 people in the region are on the waiting list for ENT care, the highest figure in the country. Of those, 11,000 have been waiting a year – almost a third of the total number in England waiting 52 weeks.

Nirmal Kumar, a consultant ENT surgeon and former president of ENT UK, which represents ENT healthcare professionals, said the backlog was “immense”. He said: “Before the pandemic, [waiting] times had come down significantly and was at the best in my more than 20 years as an ENT consultant. Now ENT is among the worst wait times.”

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He said the ENT waiting list had been “particularly badly affected” by the pandemic, because procedures were not deemed as urgent as cancer surgery, for instance. Wait times have increased for common procedures such as children’s and adults’ tonsil surgery, grommets to improve hearing in children, and sinus procedures in adults.

NHS staff are innovating to tackle the ENT backlog by performing procedures in outpatient clinics instead of operating theatres, and harnessing technology to speed up tests. But Kumar said tough decisions were having to be made about who gets treated first. “We are having to prioritise patients based on clinical need and we are using specific prioritisation guidelines developed during the pandemic.”

Tim Mitchell, a consultant ENT surgeon and vice-president of the Royal College of Surgeons of England, said that while progress had been made recently in reducing the longest waits, it was important to “make sure patients are not left waiting in limbo”. Prompt treatment was vital to end pain, hearing problems and infections and “significantly improve their quality of life,” he added.

Mitchell said the college was calling for a dedicated surgical hub in every area of England, to enable planned surgery to occur even if there are sudden pressures in other areas of the NHS. “We must also make sure we have enough staff in the NHS to meet patient demand,” he said.