Sunday, 16 June 2024
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Sunday, 16 June 2024

Department for Health and Social Care ‘overseen years of decline in the NHS’s cancer and elective care’

In its report today the Public Accounts Committee says the Department for Health and Social Care “has overseen years of decline in the NHS’s cancer and elective care waiting time performance and, even before the pandemic, did not increase capacity sufficiently to meet growing demand.”

The NHS has not met the 18-week maximum waiting time standard for elective care since February 2016 nor the eight key standards for cancer care in totality since 2014. The Committee says now that “on top of these previous failures and despite the heroic efforts of the NHS workforce, the COVID-19 pandemic has inevitably caused a further huge deterioration in the NHS’s provision of elective and cancer care.”

At the end of December 2021, 6.07 million patients were waiting for ‘elective’ care – such as hip or knee replacements or cataract surgery – the biggest waiting list since records began.

The legal standard for elective care states that 92% of people on the waiting list should be seen within 18 weeks, but only 64% (3.87 million) of these patients have been waiting less than that, and 311,000 have now been waiting for more than a year. Even before the pandemic, only 83% were being seen within 18 weeks.

Only 67% of patients with an urgent referral for suspected cancer were treated within 62 days, compared to the requirement for 85% to be treated within that time.

The Committee also noted, “a striking feature of the pandemic was that very large numbers of patients did not present at, or were unable to access routine NHS services”. As of September 2021, there were between 7.6 million and 9.1 million missing referrals of patients for elective care and between 240,000 and 740,000 missing urgent referrals for suspected cancer. People will face serious health consequences as a result of delays in treatment, with some dying earlier and many living with pain or discomfort for longer.

The Committee says “any transparent and realistic assessment of what the Department and NHSE&I expect elective and cancer care services to achieve by 2024-25” must include an “assessment of the number of staff that will be available and how staff who have been working under intense and consistent pressure will be supported”.

Dame Meg Hillier MP, Chair of the Public Accounts Committee, said:

“DHSC has overseen a long-term decline in elective and critical cancer care that is dragging our National Health Service and the heroic staff down. We on PAC are now extremely concerned that there is no real plan to turn a large cash injection, for elective care and capital costs of dangerously crumbling facilities, into better outcomes for people waiting for life-saving or quality-of-life improving treatment. Nor is it obvious that the Department finally understands that its biggest problem, and the only solution to all its problems, is the way it manages its greatest resource: our heroic NHS staff. Exhausted and demoralised, they’ve emerged from two hellish years only to face longer and longer lists of sicker people. This is compounded by staffing shortages in a number of professional areas.

“The cycle of glib headlines and fiddling with management structures must be broken, with an overhauled “people plan” that gets to the core of the desperate under-staffing and under-resourcing that have undermined our health system.”

Reacting to the report, Morgan Vine, Head of Policy and Influencing at Independent Age, said:    

“Today’s Public Accounts Committee report showcases an alarming deterioration in the NHS’s cancer and elective care waiting time performance. We know that professionals across the NHS are working incredibly hard but the reality behind these statistics is that 6 million people of all ages, including many in later life, are living in daily pain as they wait for their operation.

“Many older people stuck in this group feel like they have been abandoned as they face physical and mental deterioration that can make treatment harder. Our own research revealed the harsh reality that over half (52%) of over 50s on surgical waiting lists are in daily pain. This is unacceptable.

“This trend predates the pandemic, highlighting the scale of change needed to tackle the unpreceded backlog of people waiting for treatment. Capacity issues and the workforce crises have gone years without being addressed, leaving the health service and those who work in it less able to meet the challenges of a pandemic. No plans to reduce waiting times will get off the ground unless there is an effective workforce strategy to address the current and future needs of the NHS, including improving NHS capacity and filling job vacancies.

“At Independent Age, we want everyone to have the freedom to live well without experiencing avoidable pain and distress. While the government and the NHS have set out ambitious plans to get services on track, there remains a lot more that can be done, particularly for those living in pain as they wait for treatment. The expansion of personalised care and personal health budgets is a positive step but they need to be available to everyone who has already waited for six months or more, so they can manage their pain as effectively as possible.”


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