1.5m fewer people on waiting list than thought

No figures have previously been given for the number of separate individuals, but many in politics, policy and the media have often indicated it is the same as the total number of entries on the RTT list – which hit 7 million in August.

NHSE elective recovery chief Sir Jim Mackey, speaking at the King’s Fund annual conference in London yesterday, revealed an estimate for the first time of the number of individuals.

Sir Jim said: “It’s actually 5.5 million people, but seven million entries on the waiting list. There are around a million and a half people, we think, who are on multiple times. So, it’s a lot more complicated than we all think.”

He said it was not clear how many were patients waiting for genuinely separate issues or procedures, and how many were duplicates for the same pathway – essentially errors. Sir Jim said he hoped a new NHSE project would clarify the picture.

He said: “Sometimes there are people on twice, where they need one thing then another thing. Other times it’s a bit more complicated… We’re just about to start a process with a handful of organisations to try and work out what that means.”

The RTT list hit 7 million entries in August, up from 6.8 million in July while the number of year-plus breaches increased from around 378,000 to 388,000 between July and August, according to the most recent official statistics as reported by HSJ last month.

During his session, the Northumbria Healthcare Foundation Trust chief voiced frustration about the widespread perception of the NHS elective challenge, which he said was being portrayed more negatively than was fair, given the progress made in the aftermath of the pandemic.

As an example, Sir Jim said while there was “still an awful lot to do”, the NHS was on track to meet a target of eliminating all the 78-week waiters by March.

He said: “We are just about where we want to be at the end of October to be able to hit the end of March objective to eliminate 78 [week waiters]… The NHS is doing an absolutely fantastic job in reducing long waiters. Still an awful lot to do. Still a lot to do over winter…

“[But while] the 104-week cohort was largely surgical, the 78-week cohort is largely outpatients, so we’ve got a better chance of being able to winter proof it than we had this time last year.”

There were 50,888 78-week breaches as of August, 950 fewer than the 51,838 in July, according to the latest official statistics published last month, although NHSE has more up-to-date but not fully validated data internally.

As HSJ reported this morning, Sir Jim also admitted NHSE had “forgotten the people” when it published controversial guidelines last month which said patients faced being removed from the waiting list if they declined two appointment dates.

He said the guidance, the existence of which was exclusively revealed by HSJ, was drafted to address legitimate concerns from trusts, but that the process had been “rushed”.

Following Sir Jim’s comments, NHSE told HSJ the guidance, which had sparked widespread criticism including from patient groups, would not be changing. But Sir Jim said NHSE would “spend time” better understanding patients after “reflecting” on the process which had created the controversial guidelines.

Experts however, are still calling on NHSE to pull the guidance, including waiting list expert and HSJ columnist Rob Findlay, who tweeted in response to our article: “They should think again about that.”