London Eye: The city with one in eight on a waiting list

Nearly a million people

The good news is London is on track to clear all the two-year waiters by the target of July. The bad news is 944,726 patients are still on the waiting list, as of the latest data.

The capital is streets ahead on two-year waiter numbers, with 287 patients as of 12 June (more than half of them at Barts Health Trust).

But the nearly one million people on an incomplete pathway is not only a fair chunk of London’s 8.3 million population, it’s also up by around a quarter on the same position last year (the elective data goes up to the end of April). Over the same period, the number of one-year waiters nearly halved to 24,600.

The total increase is weirdly lumpy as well. Yes, north west London is the single biggest clinical commissioning group, covering eight London boroughs, but it reported an outsize increase in the number of people on its waiting lists. The total swelled 37 per cent between April 2021 and April 2022, with 239,000 now waiting.

Incidentally, 239,000 is a bigger population group than some London boroughs. Yes, NWL comprises eight boroughs. But two of them – Hammersmith & Fulham and Kensington & Chelsea – are among the smallest in London, according to the most recent Office for National Statistics data, with the latter not just small but shrinking. 

The populations of Newham, Tower Hamlets and Barking & Dagenham in east London have exploded. Over that same period, the waiting list in north east London increased by 19 per cent, nearly half that of NWL.

Why might this be?

Although NWL has its patches, broadly NEL has less access to primary care and always has done. Research by the Care Quality Commission and Barking, Havering and Redbridge University Hospitals Trust earlier this year bore this out, with interviewees at BHR’s emergency departments (the worst performing in the country by some way) saying they could not get to a GP.

Move to Stratford

One of the more surreal headlines this week was in The Guardian, which reported an objection to Great Ormond Street Hospital’s plan to rebuild the front of its main site from neighbouring University College London Hospitals.

UCLH’s issue was with the traffic minutiae around car parking and similar, rather than anything more existential.

More surprising was a residents group calling for GOSH to get out of their neighbourhood altogether.

In their planning objection letter to Camden Council, the group said the trust should prioritise “delivering the best possible care to children rather [than] some romantic and outdated attachment to being located in the small residential road that GOSH was originally named after”.

Citing the dust the construction work will throw up and the disruption caused more generally by the building works, the residents had a suggestion: leave.

The letter said: “A single integrated purpose-built building – perhaps even in a location like Stratford, where GOSH could offer expansive gardens and playgrounds and fresh air for the children to enjoy without constant traffic congestion and filthy air. As GOSH is no doubt aware, the increased construction dust and environmental damage caused by the construction will create additional problems for children with respiratory illnesses.

“We would commend GOSH to at least consider alternative locations for its future or remove the clinical site and keep consulting rooms and administration in its current site.”

Most NHS managers’ experience of residents groups is them asking services remain where they are, at any cost.

GOSH told London Eye in response that it had “reviewed the concerns which include suggesting we move to east London or Milton Keynes”.

The trust pointed out its proposals for a children’s cancer centre put it close to UCLH, plus the UCL Great Ormond Street Institute of Child Health and the UCL Institute of Cardiovascular Science (co-location of children’s cancer services with intensive care facilities is something we’ll be hearing a lot more about soon).

GOSH also said: “Our central London location also makes it easy for our patients to travel to receive care from across the UK or overseas.”

Actually, given the recent opening of the Elizabeth Line, you could make the argument Stratford is more accessible than Great Ormond Street. Maybe it makes more sense to provide these services largely from a brownfield site in a much cheaper part of town, selling the very valuable land to pay for it. Whatever the arguments, it would be very surprising if GOSH wasn’t celebrating its bicentenary in 2052 where it is now.