The number of people "languishing in pain" on an NHS waiting list continues to grow in Wales, latest figures have revealed. According to Welsh Government data the number of patients awaiting planned non-urgent care hit record levels for the 24th month in a row.
In April there were 707,098 patients on the waiting list – a rise from the 701,418 recorded in March and way up on the 456,809 seen just before the pandemic hit in March 2020. More than a quarter of a million people (258,189) currently on an NHS Wales waiting list have been on it for nine months or more, up on the 253,177 recorded the month before. In comparison there were only 28,294 waiting this long in March 2020.
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 rocketed.
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The government has also set a target of eliminating two-year waits for planned treatments "in most specialties" by March 2023. In April, there were 68,032 two-year waits, a slight decrease of 2,385 on the previous month. The most common treatments with waits of two years or more were in trauma and orthopaedics (19,607), general surgery (8,460), earn nose and throat (10,226) and urology (4,921).
Meanwhile Welsh Ambulance Service figures for May showed that barely half (54.5%) of immediately life-threatening "red" calls were reached within the target time of eight minutes. This is well below the 65% target but up on the 51.2%% recorded in April. The average response time to red calls was seven minutes and 22 seconds. This is 27 seconds faster than the previous month but 36 seconds slower than May 2021.
Similarly in May the median response time for amber calls, which includes strokes, was just under one hour and 18 minutes. This is almost 30 minutes quicker than in April but 30 minutes slower than in May 2021.
Last month almost 38,000 emergency calls were made to the ambulance service. This is an average of 1,207 calls per day, a decrease of 55 (4.3%) calls on average per day than the previous month and 130 (9.7%) fewer calls on average per day than the same month last year.
Last month was the 12th 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 Powys area with only 43.5% arriving within the eight-minute target.
When it came to A&E departments there was a slight improvement in the four-hour waiting times in May although it was still the third-worst performance on record. More than a third (33.4%) of people spent four hours or more in these units before being admitted, transferred, or discharged in May – an improvement on the 34.1% in April. In May there were more than 91,000 attendances to all NHS Wales emergency departments – an average of 2,937 per day which is 162 more than in the previous month.
Ysbyty Glan Clwyd recorded the worst A&E figures last month with 58.2% spending more than four hours there followed by Wrexham Maelor with 57.8% and The Grange University Hospital with 44.5%. Overall in Wales 10,226 patients waited more than 12 hours in A&E – down on the 10,391 recorded in April – but the target is for no-one to wait that long.
Welsh Government figures for March also revealed that only 56.4% of cancer patients started their treatment within 62 days – well below the national target that 75% should start their treatment on time. This was also a reduction on the 58.7%% recorded the previous month. It means that during April alone at least 623 people faced delays in receiving vital cancer treatments.
In March the cancer care system in Wales faced its busiest month on record with the number of people being for referred for a potential cancer diagnosis exceeding 15,000. Richard Pugh, head of partnerships for Macmillan Cancer Support in Wales, said: "Again this data shows a trend of worsening cancer waiting times in Wales, which mean more than four in 10 people with cancer here did not start their treatment on time in April. The figures show performance has dipped for the four most common types of cancer – breast, lung, urological, and lower gastrointestinal – and the vast majority of cancer types.
"These delays mean they and their loved ones faced distressing and worrying delays, which could impact on the success of their treatment. These worrying figures show how our cancer care system is still struggling to cope with demand despite the valiant efforts of NHS staff. We need urgent focus to improve cancer care in Wales now and in the future especially as Wales is now working towards a target of 80% of people with cancer being treated on time by 2026." Meanwhile in April the number of patients waiting longer than the target time of 14 weeks for diagnostic therapies decreased by 10.5% compared to March 2022 and is the first monthly decrease since May 2021.
Director of the NHS Confederation, Darren Hughes, said the figures show that demand on the health and care system remains "extremely high". He added: "This comes alongside a high level of life-threatening (red) calls to the ambulance service, showing demand coming through the 'front door' is relentless. Despite this performance against emergency department waiting targets, including the average time spent in them, has improved slightly. This illustrates that staff across the health and care system continue to work exceptionally hard to innovate and deliver care in the face of continuing pressures.
"Although waiting lists continue to grow the rate of growth is slowing month on month. Considering the impact of the pandemic, with patients coming forward at a later stage, there is a case for cautious optimism. However, in order to make real strides in planned care waiting times, including in diagnostics and therapies, we need to address the capacity gap across financial resilience, capital investment, and workforce. The NHS is full of committed staff and leaders but they cannot work miracles and are doing all they can with the resources they have, continuing to support current staff and attract new.
"What we don’t see in these statistics are the huge pressures across the whole system, on GPs, pharmacies, and other community services, as well as the number of patients unable to be discharged from hospital because of the ongoing pressures facing social care. Without long-term sustainable investment in the social care sector there is only so far the NHS can go in improving patient flow through hospitals and providing timely care."
Welsh Conservative and shadow health minister Russell George MS said: "I find it astonishing that the NHS waiting list in Wales is continuing to grow when the Labour Government keep insisting that things are getting better when they are demonstrably not.
"I really do feel for anyone who finds themselves languishing in pain on this directory of the damned. Their day-to-day lives could be severely hamstrung as well as their ability to earn during a cost of living crisis.
"We’ve been clear in our solutions to this emergency and while some, like our regional surgical hubs, will be coming into effect in future it is several months since we first proposed them. As always the solutions come far too late for patients who instead see Labour ministers focusing on creating more politicians in Cardiff Bay. Labour need to stop breaking all the wrong records and bring an end to these shameful numbers where one in five people are on a waiting list, one in four of them for over a year, and nearly 70,000 for two years."
In response to the overall NHS performance figures a spokesman for the Welsh Government said: "Our health services continue to recover from the effects of the pandemic. We have seen more people coming forward with health concerns but the reduction in working day due to the Easter holidays will have impacted scheduled care capacity. April saw fewer referrals for first outpatient appointments compared to the previous month.
"Emergency ambulance and emergency department staff and services remain under considerable pressure because of capacity challenges across the health and social care system. This has been accentuated recently by higher than anticipated levels of sickness absence
"There were small improvements across urgent and emergency care thanks to the hard work and commitment of staff. There were improvements in ambulance responsiveness and emergency department performance in May when compared to April and the majority of patients continue to receive safe and timely care. However we remain concerned about the levels of delay experienced by patients on occasion and are working with all stakeholders through national programmes to support improvement. It is important to note that during April 2022 over 300,000 patient consultations were undertaken by the NHS in Wales."
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