Delays to treatment

A delay to a patient’s treatment can be due to various reasons, such as too few staff leading to a long wait in A&E or lack of equipment resulting in a delay to treatment. More frequently now there are substantial waits for routine appointments to see GPs and delays in transfer of care in hospitals impacting more and more people.

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King's Fund analysis comparing health services across the 21 OECD countries showed that UK had some of the worst figures for hospital beds and doctors. UK has the third-lowest number of doctors among the 21 nations, with just 2.8 per 1,000 people. The UK also has just 2.6 for every 1,000 people, placing it 18th overall out of the 21 countries.

Delays in services and treatments are prevalent across the NHS. Waiting times in A&E, for GP appointments, treatment waiting lists and access to mental health services are all getting longer. The figures on staff numbers and hospital beds go someway to explaining the current situation.

Worst performance since records began

The NHS has national minimum waiting time targets for numerous situations. This makes it relatively easy to track how the NHS is performing in these areas.  The statistic that always makes the headlines is the wait in A&E: there is a national target that 95% of people should wait less than four hours in A&E.

Winter 2017/18 waiting times in A&E hit a record low. Only 76.4% of patients needing urgent care were treated within four hours at hospital A&E units in England during March. In addition to this, in 2016/17 the number of people waiting over 12 hours in trolleys for hospital admission from A&E rose to over 3,500 patients.

Delays in treatments have not been confined to A&E departments. The proportion of patients waiting to receive planned care in hospital within the 18 weeks guarantee also fell to its worst level. Just 87.9% of those awaiting planned care received their treatment within 18 weeks. Almost half a million patients waited longer.

Long delays in mental health services

Although the Government does not collect data on waiting times in many other areas, surveys have shown that waiting times are increasing. BMA research of CCGs revealed that 9 in 10 of those which fund talking therapies, keep no records of waiting times for the four common kinds: DBT; cognitive behavioural therapy; family therapy; and dynamic psychotherapy (Improving Access to Psychological Therapies - IAPT).

The BMA found that last year 3,700 patients waited more than six months for talking therapies and 1,500 for longer than a year. Patients in Basildon, Southend and Thurrock, waited a year and a half for it on average, as the NHS only employed a single therapist for all of south Essex.

Delays in treatment vary across the country, an example of a postcode lottery of services. Patients living in the Leicester city CCG area waited an average of 135 days last year after being referred before they had their first appointment. This is compared to Stoke-on-Trent which had the lowest waiting times, at just 5 days.

Mind said the findings should prompt NHS England to introduce a maximum four-week waiting time for IAPT care. “We have long been calling for everyone to get treatment within 28 days of being referred, and these data suggest that in parts of the country, people are still waiting far too long”.

Delays at the GP

A King’s Fund survey in 2017, public satisfaction with the NHS was the lowest it has been since the survey began in 1983. It was the first time that the GP service was not the highest rated service. One of the largest reasons for dissatisfaction was difficulty and time taken to get an appointment.

A Pulse survey in 2017 revealed that patients are now waiting an average of 13 days for routine GP appointments. A BMA patient survey in the same year reported that fewer patients said that were able to get an appointment or speak to someone at the surgery, falling to 72.1%. These delays lead more patients to A&E putting further pressure on those services.