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The Guardian - UK
The Guardian - UK
World
Nimo Omer

Friday briefing: Why NHS waiting lists are at a record high in England

The Royal Free Hospital in London.
The Royal Free Hospital in London. Photograph: Robert Stainforth/Alamy

Good morning.

New data released by NHS England has revealed that waiting lists have hit a record high. More than 7.5 million people are waiting for treatment in England. The number of people waiting for more than 18 weeks is the worst it has ever been, at over 3 million.

There have been marginal improvements: the number of people waiting for more than 52 weeks for treatment is down slightly from over 385,000 to over 383,000, but these narrow gains do not alleviate the pressure on Rishi Sunak, who promised in January that “lists will fall and people will get the care they need more quickly”.

For today’s newsletter I spoke to the Guardian’s health editor, Andrew Gregory, about the data, what it means for the NHS and how it will affect the government. First, the headlines.

Five big stories

  1. Greenpeace | The heads of Greenpeace have said Rishi Sunak’s government will “go down in history” as the administration that failed the UK on the climate crisis. The charity has described government briefings against the organisation as “really dark stuff”.

  2. Climate | The death toll from the wildfires that have ravaged the Hawaiian island of Maui has risen to 53, with officials warning that the number is expected to rise. The catastrophic fires are expected to become the state’s deadliest natural disaster since 1961.

  3. Retail | The budget retailer Wilko has called in administrators, putting more than 12,000 jobs at risk after it failed to agree a rescue deal. The family-owned household and garden products company, which has about 400 stores, is expected to have to close dozens of outlets.

  4. US | Amazon workers are being tracked and penalised for not spending sufficient time in the company’s offices, an email sent to employees this week revealed, as tech companies push back against work-from-home practices that flourished during the pandemic.

  5. Space travel | Virgin Galactic’s VSS Unity, a reusable rocket-powered space plane carrying the company’s first crew of tourists to space, successfully launched and landed on Thursday. Three private passengers were aboard the craft, including 80 year old former Olympian Jon Goodwin.

In depth: ‘The most worrying aspect is there is simply no immediate solution in sight’

Rishi Sunak during a visit to St George’s hospital in London.
Rishi Sunak during a visit to St George’s hospital in London. Photograph: Toby Melville/PA

Though Rishi Sunak may try to divert anger at yesterday’s figures towards striking junior doctors and nurses, the growing crisis in the health service will probably be blamed on his party. The Health Foundation, for instance, said that the government has created “the roots” of this problem which lies “in political failures to tackle rising pressures over the last decade”. The Liberal Democrats accused the government of “failing miserably” and “leaving millions in pain and discomfort”.

Further strikes – with junior doctors beginning their fifth round on the picket line today – will only exacerbate the problem. The NHS waiting list has now ballooned by 3 million since the start of the pandemic – and that number is only creeping higher. The latest figures are a sign of what’s to come for the government, as healthcare shapes up to be one of the most important battlegrounds in the next general election.

***

The numbers

“In simple terms, the waiting list is growing because people are joining it at a faster rate than people are leaving it – that’s why it is now at its highest level since 2007 [when records began],” Andrew says.

There was some reprieve for the prime minister: 61% of people were seen within the four-hour target in major A&Es in July which is an improvement from the 50% record low reported in December – although still well below the government’s 95% target. Ambulance response times have gotten slightly better and the number of suspected cancer patients who have been waiting more than 62 days since an urgent GP referral has also dropped slightly from 24,180 in June to 21,529 in July – last September that number stood at 34,000.

“Cancer is one area where the NHS is making some inroads, which is positive news,” Andrew says. He also points to the drive to increase early diagnostics of the disease: “the problem is patients will likely then face a wait for treatment”. The wins however are dwarfed by the staggering scale of the backlog and the small breakthroughs that have been made are all way off the targets the government have set for itself.

Andrew describes the figures as “shocking but not surprising”, adding that many people in the health service expect the waiting list figures to get worse before they get better.

***

Impact on patients

“You don’t want to get sick if it continues to go on like this,” Andrew says. The longer patients wait for treatment, the worse their condition often gets. Patients could also develop other health issues during the delays. This mean that those waiting are in more discomfort or pain for a longer period of time, and when they finally get to their appointment they’re often in a worse state than when they joined the waiting list and in need of a more complicated procedure.

“When this happens, there are higher risks of something going wrong and so the procedures might well involve more staff. It could also take longer, which again, further sets back the waiting list,” Andrew says. “One thing that struck me recently is that this is not just a statistic that we can look at and then forget about until the next month, it’s an emerging danger.”

***

Strikes

It is not government spin to suggest that the strikes have compounded the issue of long waiting lists. NHS England has said: “to date, around 778,000 hospital appointments across the NHS have been rescheduled due to strike action”, and Saffron Cordery, the deputy chief executive of NHS Providers, said “the strikes divert trusts’ resources from bearing down on backlogs to managing the disruption they cause”. It is important to note, however, that the waiting list was already at 7.2 million before the first strike in this wave of action took place last year.

Earlier this month, the government announced pay increases for millions of public sector workers, including doctors. However, the British Medical Association (BMA) has called the offer derisory. The BMA’s consultants committee chair, Dr Vishal Sharma said last month that doctors take-home pay had fallen in real terms by 35% since 2008, “a staggering figure which means effectively we are working for four months of the year for free”.

***

It’s the NHS, stupid

“Rishi Sunak has no plan to turn this around, he only offers excuses,” said Rosena Allin-Khan, Labour’s shadow minister for mental health, in response to the figures, leaving nobody in doubt that healthcare will be front and centre of the political agenda in the run up to the next general election. Having pledged to bring waiting lists down, Sunak does have at least another year to try to achieve that aim and Andrew predicts that by the time the election comes around, the number of people on the list will be lower than when Sunak made his promise.

“The big question is whether that will satisfy enough people to win him enough political progress,” Andrew says. “The most worrying aspect however for patients and the NHS is that there is simply no immediate solution in sight.”

What else we’ve been reading

Ice Cube performs onstage during day 2 of the 2023 Essence festival.
Ice Cube performs onstage during day 2 of the 2023 Essence festival. Photograph: Bennett Raglin/Getty Images for ESSENCE
  • Tayo Bero is fascinating on the allure of far-right politics to black rappers – first Kanye, now Ice Cube has been sucked in by a heady mix of hyper-masculinity and conspiracy theory. Toby Moses, head of newsletters

  • This week’s Dining Across the Divide is an interesting one as two lefties battle it out: “He’s more eat-the-rich and I’m more nibble at them, but I liked that. We need someone with big ideas,” Grainne said. Nimo

  • Confused by gen Z complimenting fit middle aged people as of “beekeeping age”? You’ve clearly not watched Rick and Morty, but fear not Zoe Williams is here to explain all. Toby

  • I urge everyone to read Michael Imperioli answers to questions from Guardian readers. He talks about moving on from The Sopranos, his faith and his new creative pursuits. Nimo

  • The artwork of Jamie Reid is instantly recognisable, seared on the cultural psyche thanks to his era defining work with the Sex Pistols; Jonathan Jones pays a fitting tribute to the punk icon. Toby

Sport

Spain’s Salma Paralluelo celebrates scoring their second goal in the Women’s World Cup
Spain’s Salma Paralluelo celebrates scoring their second goal in the Women’s World Cup Photograph: Amanda Perobelli/Reuters

Football | Spain has secured a spot in the semi-finals of the Women’s World Cup after Salma Paralluelo’s (pictured above) goal in extra time delivered the team a 2-1 victory against the Netherlands. Off the pitch, England’s breakout star Lauren James was handed a two-match ban for her red card against Nigeria, meaning she will only play again if England make the final.

Football | Harry Kane’s future is in his own hands, after Tottenham accepted a bid from Bundesliga champions Bayern Munich for the striker. The 30-year-old England captain, who has spent his entire senior career with Spurs, will probably make his decision before the team’s first game of the season this weekend.

Golf | American Ally Ewing took a one-shot lead on the first day of the Women’s Open after a late charge to finish four under at Walton Heath. With a round of 68, it put her ahead of South Korean duo Amy Yang and Jeongeun Lee who shot rounds of 69 along with Thailand’s Jaravee Boonchant, France’s Perrine Delacour and Denmark’s Emily Kristine Pedersen.

The front pages

Guardian front page 11 August
Guardian front page 11 August Photograph: Guardian

The Guardian carries an exclusive story on its front page on Friday, with “PM ‘will go down in history for failing on climate’ – Greenpeace”. The i leads with “Mortgage rates war begins as 13 lenders cut prices”. The Financial Times reports “Collapse of retailer Wilko leaves 12,500 jobs in peril”.

With a fresh round of industrial action from junior doctors, the Times says “Strikes push NHS to the brink”. The Telegraph reports on the “£1bn cost of junior doctors’ strikes”, while the Mail leads with comments from the health secretary: “Striking doctors are just ‘harming’ patients”.

The Mirror leads with “Guess who had Shell shares” above its report into Theresa Villiers time as environment secretary. Finally, the Sun reports on Harry Kane’s imminent decision on his move to Bayern Munich with “In his Hans”.

Something for the weekend

Our critics’ roundup of the best things to watch, read and listen to right now

Noname, whose new album is out this week.
Noname, whose new album is out this week. Photograph: Mahaneela

TV
The Case Against Cosby (ITVX)
This two-part documentary is based on The Moment, a memoir written by Andrea Constand, who is the only woman able to gain a conviction against Bill Cosby, on three counts of aggravated sexual assault. The story is told from the perspective of several other survivors but Constand is at the heart of this, and she describes her experiences with Cosby with courage and utter clarity. Rebecca Nicholson

Music
Noname – Sundial

Noname emerged last decade alongside Chicago peers such as Chance the Rapper, making creative, neo soul-inflected hip-hop in parallel to the city’s drill rap and jazz scenes. Here, relatively uncomplicated backings – which encompass bossa nova, jazz, soul and boom-bap hip-hop – foreground her lyrics on trauma, and some listeners will find Sundial too ethically complex and contrary. Hopefully many more will flock to Noname’s piercing intellect and joie de vivre. Ben Beaumont-Thomas

Film
L’Immensità
Emanuele Crialese’s film is a drama of family dysfunction and multi-generational unhappiness: a story of quiet desperation and secret yearning in the hearts of teens and the middle-aged alike. Hollywood might set something like this in the ’burbs. Crialese places it right in the centre of racy and prosperous Rome in 1970, with Penélope Cruz’s Clara clearly heading for a terrible breakdown. Peter Bradshaw

Podcast
The Rest Is Football
Widely available, episodes at least twice weekly

A football pundit podcast might not be groundbreaking, but this one has some of the best voices going: Gary Lineker, Alan Shearer and – he of the world’s greatest – Micah Richards. Ahead of the new season, they share “big stories, tall tales, gossips and hopefully some laughs”. Oh, and a fair bit on the actual game. Hollie Richardson

Today in Focus

Witnesses are sworn in to testify before a House Oversight and Accountability Committee hearing about UFOs.
Witnesses are sworn in to testify before a House Oversight and Accountability Committee hearing about UFOs. Photograph: Jim Lo Scalzo/EPA

How the search for UFOs reached the US Congress

Over the past few weeks, there’s been a lot of talk of UFOs; chatter that has gone beyond internet forums, YouTube channels and kooky podcasts, and arrived in Washington. The Pentagon has said pilots are seeing things up in the sky that they can’t explain, and a few weeks ago, spaceships got their day in Congress

Adam Gabbatt has the enviable task of covering UFOs for the Guardian and he was there. He tells Michael Safi how the hearing unfolded and where the investigation is going next.

Cartoon of the day | Ben Jennings

Ben Jennings cartoon

The Upside

A bit of good news to remind you that the world’s not all bad

Simonetta (left) and Juliet, pictured at the Serpentine in Hyde Park in 2023
Simonetta (left) and Juliet, pictured at the Serpentine in Hyde Park in 2023 Photograph: Karen Towns

In this week’s How we met column, Simonetta and Juliet, both 58, tell their story of meeting and becoming fast friends during the pandemic.

“Being cooped up at home I suddenly had this absolute need to be around cold water,” says Simonetta – she opted for London’s Serpentine Swimming Club in Hyde Park, London. There, she met Juliet – a technical writer who lives in China but found herself stuck in the UK lockdown, away from her partner. A shared love of boilersuits, post-swim snacks saw the pair bond – and they remain firmly in touch over WhatsApp now that Juliet has returned home.

“Interesting conversations happen when you’re half-naked getting changed in the cold,” Simonetta says.

Sign up here for a weekly roundup of The Upside, sent to you every Sunday

Bored at work?

And finally, the Guardian’s puzzles are here to keep you entertained throughout the day – with plenty more on the Guardian’s Puzzles app for iOS and Android. Until Monday.

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