The NHS marked its 75th anniversary in July 2023, which means most of us don’t remember a time when it didn’t exist. He was a constant source of debates, both political and media. We examine the data to find out what’s happening in the NHS from August 2023.
Waiting time remains a key issue
NHS waiting times were a problem before the COVID-19 pandemic, and the increased demand the pandemic has placed on NHS services has only made matters worse.
Researching the library of the House of Commons
In July 2023, the House of Commons Library published research into the demand, waiting times and performance of vital NHS services in England. Their research is sharp, revealing the seriousness of the current situation in our health service.
The waiting list for consultant-led treatment reaches 7.6 million
In June 2023, the waiting list for consultant-led treatment, often referred to as “elective care”, reached 7.6 million patients in England. To put that into context, the population of England is only 56 million people, so that’s close to 14% of us waiting for treatment!
As can be seen in the chart below, while waiting list growth has accelerated due to the COVID-19 pandemic, it has already been growing year-over-year since roughly 2012, and if past performance is anything to go by, we can expect it to continue grow.
The government has announced measures such as greater use of private hospitals to reduce this backlog, but many are not convinced that this will solve the problem. Independent charity The Health Foundation said it believed it would have a “limited effect” based on a study it carried out earlier this year.
Unfortunately for those living in England, the difficult milestone of 8 million patients waiting is not far away and will probably be the case when not.
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Demand for diagnostic tests at record levels
In 2019, before the Covid-19 pandemic, the NHS in England ordered around 23.6 million diagnostic tests. These tests include things like MRIs and CT scans, as well as non-obstetric ultrasounds and numerous others.
The level of diagnostic testing was reduced during the pandemic as the NHS focused on Covid-19. However, in recent months the number of tests has risen above pre-Covid levels.
The target of six weeks waiting for diagnostic tests has not been met since 2013
When the NHS focused on tackling Covid-19 and reduced the number of diagnostic tests on offer, the percentage of people waiting longer than six weeks rose sharply, well above the 1% target.
However, as can be seen from the graph below, while there has been some recovery, there are still between 25-30% of people who have to wait longer than six weeks.
23,499 people are waiting for cancer treatment for more than 62 days (May 2023)
Much information about cancer diagnosis and treatment focuses on waiting times after patients start treatment, not those who are still waiting to start treatment. There is no official, routinely published data on how many people are waiting for treatment and what the backlog might be.
However, House of Commons Library researchers found that NHS England has started publishing “management data” showing the number of patients waiting more than 62 days for treatment after an emergency referral from a GP with suspected cancer.
The chart below shows the number of people waiting more than 62 days, but does not include anyone waiting less than that time.
As you can see, there was a peak at the beginning of the pandemic, but then a decrease until about September 2021. Since then, the number of people waiting more than 62 days has fluctuated and remained persistently higher than pre-pandemic levels.
Government scraps two-week cancer referral targets
The government recently announced its intention to scrap the fortnightly cancer referral target, which aimed to have 93% of those referred urgently for suspected cancer be seen by a consultant within 14 days. This target has not been met since the beginning of 2018 and will now be replaced by a new “Standard for faster diagnostics“.
The standard for faster diagnosis aims for 75% of patients to receive information about whether or not they have cancer within 28 days, instead of just a consultation within 14 days.
If the goals are met, then that’s it you should lead to faster treatment. However, this new standard was introduced some 16 months ago and has yet to be achieved, although it is approaching it at 73.5% in June 2023.
This resource from Cancer Research is handy if you want to see current performance against different targets. Updated monthly, it gives you an up-close view of what’s happening with cancer in the NHS.
The strike of junior doctors
Industrial action by junior NHS doctors demanding fairer pay and conditions is underway. The dispute concerns the latest wage offer in 2022, which allowed for growth below inflation of 2%. A 2022 survey by the British Medical Association found that young doctors are feeling the impact of the cost of living crisis, with more than 50% struggling to pay their bills and around 80% cutting back on the amount they spend on food and utilities.
Statistics from NHS England showed that four days of strike action in August 2023 led to 61,200 appointments and procedures being pushed back as more than 23,000 NHS staff were off work.
At this stage, the possibility of a further strike remains. Senior NHS staff estimate further measures could mean postponed appointments reach the million mark.
Lack of staff
The summer of 2023 proved to be one of the busiest in recent years, with NHS emergency services seeing 4.42 million visits during June and July, compared with 4.37 million during the same period in 2022. There were also record numbers of appointments and diagnostic tests while staff worked to reduce wait times.
However, this is taking place against a backdrop of persistent staff shortages and increased stress among staff. Mixed teams, which include medical, nursing and other support staff, usually provide medical care, so hospitals must have sufficient staff to adequately cover the workload. In March 2023, there were 112,498 job vacancies in England. Most of them were in medical care, with more than 40,000 vacancies.
The BMA said this creates a risk of burnout among staff as they struggle with excessive workloads. Staff could take more sick time or leave the profession altogether, causing staff numbers to fall further.
The Government’s Autumn Budget Statement provided extra funding to support the NHS and social care services. He also promised a recruitment plan for additional staff and filling existing vacancies over the next 5, 10 and 15 years.
An aging population
We have an aging population, and the number of people over 85 is predicted to double in the next 25 years. While many older people are able to live independently, research has found that the demand for care has increased thanks to the rise in the number of over 75s with long-term chronic conditions. As we age, we are also at greater risk of falling and needing emergency treatment.
A recent report by Age UK, a charity working with older people, raised concerns about the ability of the NHS and social care services to work together effectively to care for older people. They describe the current approach as reactive rather than proactive. They also express concern about the burden of caring for family members and the ‘sandwich generation’, people who care for their elderly parents and their children at the same time.
The solution is likely to lie in multi-agency collaboration, more integrated services and more funding to increase staffing levels and support unpaid family carers.
Increasing pressure on general practitioners
While GPs have not taken industrial action, general practice faces many of the same problems as the wider NHS. General practitioners are the first stop for most patients. However, the number of patients per GP has increased, affecting doctors’ ability to build long-term relationships with their patients. The average number of patients cared for by a full-time GP is now 18.9% higher than in 2015.
Statistics show that in the last eight years there has been a negligible increase in the number of full-time general practitioners. This is due to a variety of factors, including declining recruitment and GPs changing their working hours to part-time instead of full-time.
The 2022 GP Patient Survey found that patient satisfaction is declining in terms of appointment availability and their overall experience. One of the most striking statistics relates to patient satisfaction with the possibility of scheduling an appointment. In 2021, 70.6% of patients had a good appointment scheduling experience; by 2022, that figure has dropped to 56.2%.
Virtual departments
The number of hospital beds in the UK has halved in the last 30 years. In the last few months, this has been accompanied by an increase in the number of virtual departments. The number of virtual beds at the end of July 2023 was 9,713, and by the end of September it is planned to further increase that number.
What is a virtual department?
The idea behind virtual wards is that they will reduce pressure on NHS estates and allow NHS staff to manage patient care remotely. The idea is that staff can provide hospital treatment without the need for a hospital bed. There are daily check-ups and staff can offer home visits, prescribe medication and order tests or scans as needed.
This type of treatment is still in its infancy. Research shows that selecting the right patients is crucial, as is developing an appropriate multidisciplinary team. This approach is unlikely to provide a quick and easy solution, but it could make a positive difference with the right support.
New health campaigns and partnerships
Health education is key to improving outcomes for patients and reducing the burden on NHS services. One of the most recent campaigns focused on teaching people to recognize the signs of a heart attack and when to call 911. Early treatment increases a patient’s chances of survival, but patients often ignore early indications.
There’s also a new partnership with Morrisons, which puts cancer awareness labels on its own brand of underwear. The labels will include information about testicular cancer in boxers and breast cancer in crop top bras to increase awareness and encourage self-examination.
Getting professional advice
The NHS continues to face significant challenges in attracting and retaining its workforce and coping with increased patient demand. Private healthcare and health insurance can provide an alternative to NHS care by offering virtual GP appointments, diagnostic tests and private surgeries.
At myTribe, we offer guides and information to help you understand your options and make informed choices about your health care. If you want to know more about private health insurance, contact us for a comparative offer. We will refer you to a high-quality, regulated broker to provide advice tailored to your circumstances.
Waiver: This information is general and what is best for you will depend on your personal circumstances. Talk to a financial advisor or do your own research before making a decision.
