NHS waiting lists continue to grow with 44% of trusts missing non-urgent care targets in November 2018 and 38% failing to meet waiting times standards for cancer care in the same month, the NAO has found.
For non-urgent ‘elective’ care, 87.3% of patients had been seen within the NHS’s target of 18 week, against the NHS standard of 92%.
Clearing the backlog in elective care alone – to bring it back to March 2018 standards – would cost £700m, according to the report.
The NAO said: “Constraints on capacity, including lack of finance, staff and beds, is linked with the decline in waiting times performance.”
For cancer care the NHS has set a standard of treating 85% of patients within 62 days of an urgent referral form a GP, but just 78.6% of patients were seen within this timescale between July and September 2018. This standard has not been met since 2013.
Extra pressure has been put on cancer waiting times due to NHS England’s policy of encouraging more urgent referrals to improve early cancer diagnosis. This has seen urgent cancer referrals rocket by 94% between 2010-11 and 2017-18.
Referrals for elective care rose by 17% between 2014 and 2018 but the NAO said the reasons behind this increase are “less well understood by the NHS” compared to increased cancer referrals.
Amyas Morse, head of the NAO, said: “The NHS’s actions to increase the number of urgent cancer referrals are a positive step. They have helped to diagnose more patients at earlier stages, leading to better outcomes, even though this has meant that waiting times commitments for cancer car are no longer being met.
“However, there has been insufficient progress on tackling or understanding the reasons behind the increasing number of patients now waiting longer for non-urgent care. With rising demand for care as well as constraints in capacity, it is hard to see how the NHS will be able to turn around this position without significant investment in additional staffing and infrastructure.”
The NAO recommended that NHS England and NHS Improvement should set out how they will address declining waiting time performance and look closer at the impact of delays on patients.
Tim Gardiner, senior policy fellow at the Health Foundation, said: “There are now over half a million people waiting more than 18 weeks to start consultant–led treatment, up from 150,000 five years ago. For most people these waits will be uncomfortable and inconvenient, but in some cases they could result in harm and worse outcomes.”
NHS Improvement has been contacted for comment.
