Warning NHS waiting lists could take up to seven years to return to pre-pandemic levels

NHS waiting times could take up to seven years or more to return to pre-pandemic levels, the Auditor General for Wales has warned.

A new report released today highlights the scale of the challenges facing the Welsh Government and the health system as it struggles to deal with the scale of demand.

In February 2022 there were nearly 700,000 patients in Wales waiting for non-urgent treatment – double the number two years earlier.

Over half of the people currently waiting have yet to receive their first outpatient appointment meaning that they may not know what they’re suffering from and their care cannot be effectively prioritised.

Despite the hundreds of thousands of people in Wales waiting to start treatment today’s report notes that waiting times “have not been met for many years.”

Audit Wales has warned that unless “concerted action” is taken, returning NHS waiting times to pre-pandemic levels could take up to seven years.

Whilst referrals for a first outpatient appointment had been rising for years, they fell dramatically at the start of the 2020 and have not completely returned to pre-covid numbers.

Audit Wales estimates that, compared to pre-pandemic numbers, there are 550,000 ‘potentially missing’ referrals that could find their way back into the system.

It warns that if even half of the potentially missing referrals need treating, this will have a major effect on waiting list recovery and would increase the risk of harm from delays in patients accessing the care they need.

To help tackle the waiting times backlog the Welsh Government made an extra £200 million available during 2021-22, however, NHS bodies could not use it all.

They bid for and were allocated £146 million, but £12.77 million was returned to the Welsh Government at the end of March 2022.

NHS bodies cited staff capacity, lack of physical space and limited private capacity to carry out planned care as barriers to spending the additional funding.

As part of its “Transforming and Modernising Planned Care and Reducing Waits in Wales” plan, the Welsh Government has now allocated an additional £185 million annual funding for four years up to the end of 2025-26.

However Audit Wales said that whilst extra funding is needed, this alone will not solve the problems that the NHS faces.

It says that “serious barriers” including the on-going impact of COVID on services, reducing the impact of emergency care on planned care service delivery and long-standing staff shortages and recruitment issues, need to be repaired.

Adrian Crompton, Auditor General, said: “The COVID-19 pandemic will leave the NHS with many enduring legacies not least the significant impact it has had on waiting times for planned care.

“Just as the NHS rose to the challenge of the pandemic, it will need to rise to the challenge of tackling a waiting list which has grown to huge proportions.

“Concerted action is going to be needed on many different fronts, and some long-standing challenges will need to be overcome.

“Additional money has been made available and it is imperative that it is used to best effect to ensure there are equitable and targeted approaches that meet the planned care needs of the people of Wales.”

Five recommendations have been put to the Welsh Government following the release of today’s report, including:

• Working with health bodies to set appropriately ambitious delivery targets
• Producing a clear funding strategy including long term capital investment
• Developing a workforce plan to build and maintain planned care capacity
• Implementing system leadership arrangements to drive through the plan
• Ensuring its arrangements focus on managing clinical risks associated with long waits, supporting patients while they wait, and delivering care efficiently and effectively

Commenting on today’s report, Rhun ap Iorwerth MS, Plaid Cymru’s spokesperson for health and care said: “To see that funds were unspent proves how unsustainable and under-staffed our NHS desperately is.

“Without the right people in the right place, the Welsh Labour Government can’t begin to effectively tackle the record waiting times. What’s frustrating is that we’ve been saying this for years – long before we heard of COVID-19.

“The challenge now is much more than getting back to how things were before the pandemic – our NHS needs to be put on a more sustainable footing and we need a more comprehensive plan that addresses all stages of a patient’s journey through the system, that joins up health with social care, and that has a clear focus on prevention.”

Welsh Conservative and Shadow Health Minister Russell George MS said the report will “not fill the people of Wales with the confidence they need that their taxes are delivering positive health outcomes and that they have a well-functioning health service.”

He said: “No one blames the hard-working doctors and nurses but the poor lack of planning from the Labour Government that occupy their time prioritising more politicians in Cardiff Bay than resolving the cataclysmic state of NHS waiting lists and the increased cost-of-living.

“It was a Labour health minister that said it would be foolish to have an NHS recovery plan before the end of the pandemic. This attitude has clearly been crucial in leading 1-in-5 people to be on an NHS waiting list, with 70,000 of them languishing in pain for over two years.

“Hopefully, this report is a wake-up call for the Labour Government to get a move on and show some leadership instead of leaving health boards to do all the heavy lifting. Labour need to get a grip on the NHS and stop breaking all the wrong records.”