Trusts must ‘stabilise’ waiting lists and eliminate two-year waiters by March

NHS England and Improvement planning guidance, released this afternoon, admitted recent “non-elective pressures, including a rise in covid-19 admissions as well as workforce supply constraints” had slowed the recovery in elective waits.

The latest figures, for July, showed 293,000 people waiting more than a year for elective care, down from a record of 436,000 in March. Around 7,800 people were waiting more than two years.

The guidance said the centre would “work with systems and providers to agree individual trajectories” on holding the number of year-plus waiters to current levels, while “stabilis[ing] waiting lists around the level seen at the end of September 2021”.

The total waiting list stood at a record 5.6 million people in the most recent data. Trusts have been forced to carry out patient harm reviews after people waited longer than they should or were lost in the system.

Former NHS Improvement chief executive Jim Mackey was put in charge of recovering the treatment backlog earlier this month.

The guidance also acknowledged the “sustained pressure” on accident and emergency departments over the summer and said the usual winter activity spikes would “likely be exacerbated” by a “significant number of covid hospital admissions” and a flu season that could be 50 per cent larger than normal.

Trusts have been asked to take “immediate action” to “eliminate 12-hour waits in emergency departments” and reduce ambulance handover delays.

In August, A&E performance hit a record low despite lower attendances than in August 2019. There were also 2,794 12-hour-plus waits in the same month. This is lower than the record of 3,825 in January but is eight times higher than the total for August 2019.

On cancer services, the guidance asked trusts to return the numbers of people waiting for longer than 62 days for a cancer referral to pre-pandemic levels by March 2022.

The document also set national targets for reducing referrals to hospital outpatient appointments.

It said systems would have to submit data proving they had cut “unnecessary” referrals with a “minimum of 12 advice and guidance requests per 100 outpatient first attendances” by March 2022.

There are also targets for cutting the number of routine follow-up appointments for patients.

Systems have been told to “ensure” that 1.5 per cent of patients for “at least five major outpatient specialties” be moved or discharged to a “patient initiated follow up” pathway by December. By March 2022, hospital trusts must place 2 per cent of patients in these specialties on a PIFU pathway.