Wales' health minister says she is "determined to relieve people of their pain as soon as possible" in the wake of worsening NHS waiting times. Eluned Morgan admitted it was "not surprising" to see a deterioration in performance across January and February as they tend to be months where the health service struggles.
However, she said typical winter pressures were compounded by a huge rise in the Omicron variant of coronavirus and her call to health boards to divert resources to the booster vaccination programme. Despite a fall in the Covid infection rate throughout February the BA.2 subtype has seen cases surge once again to more than 400 cases per 100,000 population.
Speaking on Thursday morning, Ms Morgan said it was an "incredible achievement" to keep the increase in waiting times to a minimum at a time of "massive, massive pressure". "I'm really grateful for the heroic efforts that have been undertaken by our health staff in what is a really pressurised time," she said.
Latest data from the Welsh Government shows that the number of people on waiting lists for non-urgent hospital treatment hit record levels for the 21st month in a row. In January there were 688,836 people on the waiting list – a rise from the 683,331 recorded in December 2021 and way up on the 456,809 seen just before the pandemic hit in March 2020.
A quarter of a million people (250,892) currently on an NHS Wales waiting list have been on it for nine months or more, up on the 245,082 recorded the month before. In comparison there were only 28,294 waiting this long in March 2020. Worse still, the number of patients waiting in excess of two years for treatment in Wales has reached a record 56,515 - in January 2020 that figure was just 234. The largest number of patients currently waiting are for trauma and orthopaedic treatment (98,389), general surgery (85,400), ear, nose and throat (57,227), and urology (41,483).
The health minister added: "We are also focusing on long waiters and the January figure for waits over a year has shown a 2% decrease compared to December and is the lowest since August 2021. We're really starting to eat away at the people who have been waiting longer than that's really significant."
The Welsh Government wants 95% of patients to wait less than six months (26 weeks) and no-one to wait nine months (36 weeks) from referral to treatment. But when ministers made the decision to cancel all non-urgent outpatients and appointments to focus on Covid cases in March 2020 these waiting lists skyrocketed.
Meanwhile Welsh Ambulance Service figures for February showed that barely half (55%) of immediately life-threatening "Red" calls were reached within the target time of eight minutes. While this is well below the 65% target it was an improvement on the 52.5% recorded in January. The average response time to Red calls was seven minutes and 23 seconds. This is 16 seconds faster than in January, but just over a minute slower than in February 2021.
February was the ninth month in a row where, on average, there were more than 100 immediately life-threatening calls made each day. The slowest ambulances to reach life-threatened patients were in the Cwm Taf Morgannwg UHB area with only 46.9% arriving within the eight-minute target. Jason Killens, chief executive of the Welsh Ambulance Service, confirmed this week that the Armed Forces would stop volunteering as emergency drivers on March 30 which is likely to lead to some patients "waiting longer in the coming weeks" for an ambulance.
Ms Morgan said: "We are concerned about the fact that the Army will be withdrawing their support in the next few weeks, and there may be a little bit of a gap [in performance] between between the new recruits coming in and the Army support leaving. But we've carried out a huge recruitment campaign, with 136 recruits in 2020/21 and a further 127 in 21/22. But we would ask people to use the NHS 111 service so that they can be directed to the best support the right support at the right time."
When it came to A&E departments there was a dip in performance in the four-hour waiting times in February. Some 33.4% of people spent four hours or more in these units before being admitted, transferred, or discharged in February - up on the 31.8% in January. It comes despite attendances falling from 74,893 in January to 73,518 in February.
Wrexham Maelor Hospital recorded the worst four-hour A&E figures last month with 41.8% followed by Ysbyty Glan Clwyd with 49.2% and Prince Charles Hospital with 55.3%. Overall in Wales 9,150 patients waited more than 12 hours in A&E – up on the 8,998 recorded in January – but the target is for no-one to wait that long.
The health minister highlighted that delays in the discharge of patients from wards back into their own homes in a timely manner was having a massive knock-on effect for A&E departments. She said: "There's still about 1,000 people in our hospitals who are ready to be transferred out but they can't because of the fragility of our care system and our waiting packages. So we're constantly trying to address that issue. The fact that the real living wage will be introduced in April will attract more people to [work in social care], but there's a lot more work to do in that space."
Welsh Government figures for January also revealed that only 53% of cancer patients started their first definitive treatment within 62 days of it first being suspected – a fall on the 58.6% recorded the previous month and below the target of 75%. It means that during that month, an estimated 700 people faced delays in receiving vital cancer treatments.
There was substantial variation between health boards, with Cwm Taf Morgannwg UHB seeing just 42.4% of cancer patients within 62 days of first being suspected of cancer compared with 61.4% of patients in Betsi Cadwaladr UHB. Cwm Taf Morgannwg UHB has been the worst-performing health board for the eighth month in a row, and no health board has met the 75% target since it was set in February 2021.
In response to the overall NHS performance figures, a spokesperson for the Welsh Government said: "The Omicron wave continues to have an impact on staffing levels, which placed a considerable strain on the NHS, with January 2022 seeing the highest level of staff sickness due to Covid since April 2020.
"Despite the number of staff absences, thanks to the heroic efforts of our NHS staff, January saw the second smallest month-on-month increase of the total waiting list since the start of the pandemic. Unfortunately the combination of staffing, winter pressures and the ongoing Omicron wave meant some people continue to wait longer for treatment than we would like, with the over 36 week position increasing again this month. Consultants continue to see all patients in order of clinical priority, with the most urgent patients seen first."
They added: "As ever cancer services are in high demand referrals to cancer services have increased from December 2021. Whilst the number of patients starting cancer treatments decreased in January 2022, the number of patients told they do not have cancer increased on previous months with over 11,500 patients informed they do not have cancer.
"This is in part due to the opening of rapid diagnostic centres (RDC) across Wales which have helped to diagnose patients with concerning symptoms more quickly. These clinics coupled with the £248m to support our NHS recovery plan, will help us to reduce waiting times for cancer services in the coming months."
In April, the Welsh Government will be publishing its plan for how to tackle the waiting times for patients whose treatment has been delayed by the pandemic. Ms Morgan added: "We're hoping by April things will calm down a bit. There's no guarantees, and we still don't know whether we'll see another wave or something completely different at another time. But we are determined to get through this. We know that there are people who are genuinely in pain across the whole of Wales, and I'm absolutely determined to relieve them of that pain as soon as I can."
