The Government “has overseen years of decline” in NHS surgery and cancer care and needs a better plan for how it's going to achieve better outcomes.
That’s according to the latest report from the Public Accounts Committee (PAC), which said that even before the pandemic, the Department for Health and Social Care (DHSC) did not increase NHS capacity sufficiently to meet growing demand.
The pandemic has seen waiting lists hit record highs, with the amount of time patients can expect to wait also rapidly increasing. As of the end of January, there were a record 6.10 million people waiting for elective treatment, such as knee and hip operations, at NHS hospitals in England.
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At Liverpool Women's NHS Foundation Trust, there is an average wait of 18 weeks (49.9% have been waiting less than 18 weeks), with a total of 13,326 people on the waiting list for elective treatment at the end of January, including 406 waiting over a year and one over two years. More details of how the NHS trusts on Merseyside compared are shown further down this story.
Just 62.8% of people on the list at NHS hospitals in England had been waiting less than 18 weeks, the worst performance since February 2008. The target is that 92% of people wait less than 18 weeks from when they are first referred, but as the PAC points out this benchmark hasn’t been hit since February 2016, well before the pandemic.
As part of its Elective Recovery Plan, the Government has said no one will wait longer than two years for treatment by July 2022, with waits of over a year eliminated by March 2025. In January, 23,778 patients had been waiting more than two years for treatment, up from 20,065 in December, and a big rise from 2,608 in April 2021.
There were 311,528 people who had been waiting more than a year - one in 20 people on the list. Since records began in August 2007, the NHS has never seen a month where no patients were waiting more than a year.
Heroic NHS staff in Merseyside and Cheshire
The ECHO asked regional NHS team for a comment and a spokesperson for the NHS in Cheshire and Merseyside said: "We are profoundly grateful to NHS staff across Cheshire and Merseyside for their ongoing commitment and dedication, and their heroic work responding to the pandemic and the impact it has had on NHS services, including waiting times.
"We would urge anyone with symptoms they are concerned about to come forward, so that they can be seen, diagnosed and treated as quickly as possible."
How do your local trusts compare:
LIVERPOOL HEART AND CHEST HOSPITAL NHS FOUNDATION TRUST - average wait 7.9 weeks (82.3% have been waiting less than 18 weeks), with a total of 3,890 people on the waiting list at the end of January, including 52 waiting over a year and four over two years.
LIVERPOOL WOMEN'S NHS FOUNDATION TRUST - average wait 18 weeks (49.9% have been waiting less than 18 weeks), with a total of 13,326 people on the waiting list at the end of January, including 406 waiting over a year and one over two years.
THE CLATTERBRIDGE CANCER CENTRE NHS FOUNDATION TRUST - average wait 5.5 weeks (99% have been waiting less than 18 weeks), with a total of 628 people on the waiting list at the end of January, including zero waiting over a year and zero over two years.
LIVERPOOL UNIVERSITY HOSPITALS NHS FOUNDATION TRUST - average wait 16 weeks (54.6% have been waiting less than 18 weeks), with a total of 72,154 people on the waiting list at the end of January, including 6,028 waiting over a year and 384 over two years.
SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST - average wait 8.5 weeks (79.2% have been waiting less than 18 weeks), with a total of 11,551 people on the waiting list at the end of January, including 140 waiting over a year and one over two years.
WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST - average wait 11.5 weeks (67.6% have been waiting less than 18 weeks), with a total of 28,665 people on the waiting list at the end of January, including 475 waiting over a year and four over two years.
ST HELENS AND KNOWSLEY TEACHING HOSPITALS NHS TRUST - average wait 10.6 weeks (70.1% have been waiting less than 18 weeks), with a total of 30,910 people on the waiting list at the end of January, including 1,389 waiting over a year and 49 over two years.
ALDER HEY CHILDREN'S NHS FOUNDATION TRUST - average wait 13.8 weeks (62% have been waiting less than 18 weeks), with a total of 18,339 people on the waiting list at the end of January, including 223 waiting over a year and seven over two years.
THE WALTON CENTRE NHS FOUNDATION TRUST - average wait 7.9 weeks, with a total of 9,802 people on the waiting list at the end of January, including 96 waiting over a year and 10 over two years.
Missing targets
NHS Trusts were also routinely missing cancer treatment targets, both before and during the pandemic. In January, performance was the worst it's been on record for eight out of nine standards set for diagnosis and treatment.
Just 61.8% of patients with an urgent referral for suspected cancer were treated within 62 days, compared to the requirement for 85% to be treated within that time. That target hasn’t been hit since April 2014.
The number of people waiting more than two months was 5,161 in January. The Government has pledged to return the number waiting over 62 days to pre-pandemic levels, which were around 3,200 a month.
It’s also pledged to hit a recently introduced target for 75% of patients to be told they do or don’t have cancer within four weeks of an urgent referral. In January, this standard hit a 10-month low, with just 63.8% of patients getting the news in 28 days.
What are cancer diagnosis and treatment times like at your local trusts
LIVERPOOL HEART AND CHEST HOSPITAL NHS FOUNDATION TRUST - 40.9% of patients were told they did or didn't have cancer within 28 days, and 85.3% of those urgently referred started treatment within 62 days.
LIVERPOOL WOMEN'S NHS FOUNDATION TRUST - 54.1% of patients were told they did or didn't have cancer within 28 days, and 34.8% of those urgently referred started treatment within 62 days.
THE CLATTERBRIDGE CANCER CENTRE NHS FOUNDATION TRUST - 57.1% of patients were told they did or didn't have cancer within 28 days, and 78.2% of those urgently referred started treatment within 62 days.
LIVERPOOL UNIVERSITY HOSPITALS NHS FOUNDATION TRUST - 57.8% of patients were told they did or didn't have cancer within 28 days, and 56.4% of those urgently referred started treatment within 62 days.
SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST - 62.6% of patients were told they did or didn't have cancer within 28 days, and 67.7% of those urgently referred started treatment within 62 days.
WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST - 70.5% of patients were told they did or didn't have cancer within 28 days, and 79.6% of those urgently referred started treatment within 62 days.
ST HELENS AND KNOWSLEY TEACHING HOSPITALS NHS TRUST - 70.7% of patients were told they did or didn't have cancer within 28 days, and 83.4% of those urgently referred started treatment within 62 days.
ALDER HEY CHILDREN'S NHS FOUNDATION TRUST - 100% of patients were told they did or didn't have cancer within 28 days, and 100% of those urgently referred started treatment within 62 days.
Concerns there is no real plan
Dame Meg Hillier MP, Chair of the PAC, said: "DHSC has overseen a long-term decline in elective and critical cancer care that is dragging our National Health Service and the heroic staff down. We on PAC are now extremely concerned that there is no real plan to turn a large cash injection, for elective care and capital costs of dangerously crumbling facilities, into better outcomes for people waiting for life-saving or quality-of-life improving treatment.
"Nor is it obvious that the Department finally understands that its biggest problem, and the only solution to all its problems, is the way it manages its greatest resource: our heroic NHS staff. Exhausted and demoralised, they’ve emerged from two hellish years only to face longer and longer lists of sicker people. And this is compounded by staffing shortages in a number of professional areas.
"The cycle of glib headlines and fiddling with management structures must be broken, with an overhauled “people plan” that gets to the core of the desperate under-staffing and under-resourcing that have undermined our health system."
"We have set out our action plan to deal with the Covid backlog and deliver long-term recovery and reform"
The DHSC said the pandemic had put unprecedented pressures on healthcare and the department is tackling this head on.
A spokesperson said: "We have set out our action plan to deal with the Covid backlog and deliver long-term recovery and reform, backed by a record multibillion-pound investment over the next three years, and our Ten-Year Plan on cancer.
"We are clear that business as usual is not enough. That’s why we are delivering brand new surgical hubs and another 100 community diagnostic centres providing an extra nine million scans, checks and procedures by 2025."
