Covid-19 pressure on NHS highlighted as waiting list hits another record high

Ian Jones and Tom Pilgrim, PA
·6-min read

Charities and health organisations warned of the Covid-19 pandemic’s “catastrophic” impact on NHS services as new figures revealed that the number of people in England waiting to begin hospital treatment has risen to a new record high.

According to data from NHS England, a total of 4.7 million people were waiting to start treatment at the end of February 2021 – the highest figure since records began in August 2007.

The number of people waiting more than 52 weeks to start their hospital treatment stood at 387,885 in February 2021 – the highest number for any calendar month since December 2007.

A year ago, in February 2020, the number of those having to wait more than 52 weeks to start treatment stood at just 1,613.

Patients in England waiting more than 52 weeks to start hospital treatment
(PA Graphics)

Health workers have faced enormous pressures throughout the pandemic, which has pushed up hospital waiting times.

Prime Minister Boris Johnson said the Government will ensure the NHS has the funds it needs to tackle the build-up in waiting lists.

“We do need people to take up their appointments and to get the treatment that they need,” he said.

“We’re going to make sure that we give the NHS all the funding that it needs, as we have done throughout the pandemic, to beat the backlog.”

NHS England highlighted that staff had delivered almost two million operations and other elective care in January and February, one of the busiest periods of the pandemic.

It said around two in five of all patients who have received hospital treatment for Covid-19 were admitted in those first two months of the year.

Dr Susan Crossland, president of the Society for Acute Medicine, said: “This data shows pressure is high and growing despite the fall in Covid cases and this was prior to the country starting to come out of lockdown.

“Just this week the workload in acute medical units has felt to many like the pre-pandemic ‘eternal winters’ we had been working through for too long.

“The scale of pressure on the system is illustrated by the fact the number waiting more that 12 hours in an ED (emergency department) last month has doubled compared to March in 2019 pre-pandemic despite overall attendances and admissions being vastly reduced.”

Patients waiting for NHS hospital treatment in England
(PA Graphics)

Chris Hopson, chief executive of NHS Providers, said the figures showed “how hard trusts are working to recover care backlogs as well as the size of the future challenge they face, despite a decline in Covid-19 patients”.

Figures also showed that the number of people admitted for routine hospital treatment was down 47% in February compared with a year earlier.

Some 152,642 patients were admitted for treatment during the month, compared with 285,918 in February 2020.

Because 2020 was a leap year, February contained 29 days rather than the usual 28.

The year-on-year decrease recorded in January was 54%, while in December 2020 the drop was 25%.

Data shows 1.9 million elective procedures or support for patients took place amid the recent winter surge of Covid-19 infections and there were some 2.6 million A&E visits in that period, NHS England said.

Figures also show that 174,624 urgent cancer referrals were made by GPs in February, compared with 190,369 a year before – a year-on-year drop of 8%.

This follows a year-on-year fall of 11% in January but an increase of 7% in December 2020.

Urgent referrals where breast cancer symptoms were present – though not initially suspected – were down from 13,627 in February 2020 to 12,199 in February 2021, a fall of 10%.

Meanwhile, almost 330,000 patients had been waiting more than six weeks for a key diagnostic test in February.

A total of 327,663 patients were waiting for one of 15 standard tests, including an MRI scan, non-obstetric ultrasound or gastroscopy, NHS England said.

The equivalent number waiting for more than six weeks in February last year was 29,832 and the monthly total peaked at 571,459 in May 2020.

Sara Bainbridge, head of policy at Macmillan Cancer Support, said the data “further illustrates the catastrophic impact of Covid-19 on cancer diagnosis and treatment”.

She added: “Tens of thousands of people are still missing a diagnosis due to disruption caused by the pandemic, which could affect their prognosis.”

Tim Mitchell, vice-president of the Royal College of Surgeons of England, said: “The NHS had a brutal start to the year because of the second wave of Covid-19, and this is reflected in today’s figures.

(PA Graphics)
(PA Graphics)

“Although we did see the number of patients with Covid-19 decline in February, hospitals were still under huge pressure due to having to separate Covid and non-Covid care, staff having to isolate or being ill with the virus, and the massive resource needed to support the essential national vaccination effort.

“Although the most urgent operations, for cancer and life-threatening conditions, went ahead, hundreds of thousands of patients waiting for routine surgery such as hip and knee operations, cochlear implants and vascular operations had their treatment cancelled or postponed.”

A&E attendances at hospitals last month rose 10% year on year, but this is partly a reflection of the lower-than-usual numbers for March 2020, which were affected by the start of the coronavirus pandemic.

A total of 1.7 million attendances were recorded in March 2021, up from 1.5 million in March 2020, with the equivalent figure for March 2019, a non-pandemic year, being 2.2 million.

Emergency admissions to A&E departments also rose last month, to 503,913 from 427,968 in March 2020.

The year-on-year change will again have been affected by the lower-than-usual numbers for March 2020, and the equivalent figure for March 2019 was 555,457.

(PA Graphics)
(PA Graphics)

NHS England national medical director Professor Stephen Powis said: “Treating 400,000 patients with Covid-19 over the course of the last year has inevitably had an impact on the NHS, but it is a testament to the hard work and dedication of staff that they managed to deliver almost two million ops and procedures in the face of the winter wave and improve waiting times for them, along with A&E and ambulance services.”

NHS England also said February saw 22,000 people begin treatment for cancer, in line with February 2020, while the 174,000 people being referred for cancer checks was twice as many as during the peak of the first Covid-19 wave in April last year.

It added that the time taken for ambulances to reach “category one” patients, whose condition is classed as life-threatening, fell to six minutes and 47 seconds against a seven-minute target.

It said a £1 billion elective recovery fund will help trusts to restore operations and other services, with every area of the country being asked to “maximise their capacity to provide care for as many urgent and non-urgent patients as possible”.