People waiting for hospital treatment nearly six times higher since pandemic hit

Watch: Video report by ITV Wales Correspondent, James Crichton-Smith

The number of people in Wales waiting more than 36 weeks for planned hospital treatment is nearly six times higher than at the start of this year, figures have revealed.

The NHS performance figures show there are nearly 169,000 people currently waiting to start treatment, compared to 27,314 in January.

It comes as the health minister stressed that the pandemic has had an impact on "every aspect of healthcare”, with ambulance response and A&E waiting times also higher.

The figures have sparked calls for the prioritisation of patient and staff testing, along with the continued guarantee of appropriate PPE, and dedicated Covid-secure hospital wards.

An additional £30m in funding to support urgent and emergency care services through the winter period has been announced by the Welsh Government.

The amount of people waiting to start treatment in Wales is around 170,000. Credit: ITV Wales.
  • Patients waiting more than 36 weeks for planned treatment up by 500 per cent since January

Figures show that 168,944 patients have been waiting more than 36 weeks from the date the referral letter was received by the hospital.

This is the highest since current data collection began in October 2011. It means that 32.6 per cent of patients are spending more than nine months on waiting lists. 

Compared to one year ago the number of people included in these lists has risen by 800 per cent.

  • Ambulance response times to most serious calls poorest since current system introduced

Statistics show a decrease in the average number of daily ‘serious’ calls in October, with the percentage of red calls receiving a response within eight minutes also decreasing to the lowest figure since the current system was introduced in October 2015. 

In October 2020 there were 37,562 emergency calls made to the ambulance service, an average of 1,212 calls per day. Calls to the ambulance service are categorised as red, amber or green depending on the urgency of the call.

The target for the ambulance service is to make sure that they arrive within eight minutes at the scene of a red call at least 65 per cent of the time, but the figures show that the target is not currently being hit.

The table shows that the target set for the ambulance service is currently not being hit. Credit: Stats Wales
  • A&E waiting times improved, but less people attending

Waiting times in A&E have also increased on average since the pandemic hit earlier this year.

Over the past 5 years, the percentage of patients admitted, transferred or discharged within the 4 hour target has fluctuated from month-to-month but has tended to be close to 80 per cent.

Figures indicate that through March, April and May a higher percentage of patients were admitted, transferred or discharged within the 4 hour target time. This peaked in May where 84.4 per cent of patients spent less than the target time in emergency departments across Wales. 

During the early part of the pandemic the median waiting time decreased, to a low point of 2 hours in April 2020, but the median has since returned to a similar level as before the pandemic.

The amount of time people were spending in A&E may have dropped in the early stages of the pandemic due to the lower number of people attending, but in the latest months 4,360 patients spent 12 hours or more in an emergency care department, from arrival until admission, transfer or discharge.

The table shows a significant drop in waiting times in the early stages of the pandemic. Credit: Stats Wales
  • Number of referrals for outpatient appointments down

The figures show a large reduction in the number of referrals for first outpatient appointments in March 2020, during the early weeks of the Covid-19 pandemic.

The average number of daily referrals fell from around 3,750 in February to around 1,300 in March when the first lockdown was introduced. This figure improved by September where there was an average of 2,997 referrals for first outpatient appointments per day.

This is an increase of nearly 20 per cent, or 497 more referrals per day on average, compared to August this year, but it was still a decrease of 19.6 per cent, or 731 fewer referrals per day on average, compared with September 2019.

Health minister Vaughan Gething said that "every aspect of healthcare was under stress". Credit: PA images.

Health minister Vaughan Gething said the number of scheduled treatments the NHS is able to deliver in one day has halved.

"Operating with new social distancing restrictions, strict infection control and other measures to keep people safe, mean the NHS is only able to carry out about half the number of procedures every day, compared to pre-pandemic levels."

He added that the time it takes to put on the required level of PPE, as well as the deep clean of vehicles after call outs, has had an impact on ambulance response times.

"While in the early part of lockdown our emergency departments saw a fall in the usual footfall, demand has begun to return to normal levels at a time when they are now operating with reduced capacity due to infection control and physical distancing requirements.

"All our health boards now have plans in place to operate under these new circumstances and to see patients in order of clinical priority. 

"However, just as in other UK nations, it will take a long time to return to the position we were in before the pandemic."

On Tuesday, the chief executive of NHS Wales warned that despite efforts to minimise them, waiting times would continue to rise as health services respond to the pandemic.

Dr Andrew Goodall explained how there has been a need for more staff breaks due to the "heat and difficulty" of wearing PPE.

He also said the time it takes for outpatient services to clean between each appointment has doubled, from 15 to 30 minutes, whilst stating that doctors were only able to see half as many patients as in normal circumstances.

But, he added that there are some areas where the risk is higher and an even longer wait between appointments is needed.

"There has been a significant increase in the number of remote consultations to avoid the need to physically attend – around one in three of our patients are now seen virtually.

"The number of outpatients being seen has increased since the start of the pandemic, but outpatient numbers are still around a third lower than normal levels.

"Despite everything we have been doing, waiting lists are increasing because of the impact of the pandemic and the measures we have put in place to protect people’s safety."

Dr Andrew Goodall has said staff are feeling the effect of consistently having to wear PPE. Credit: Welsh Government.

The BMA described the figures as "stark" but "unsurprising", and called for the prioritisation of patient and staff testing, along with the continued guarantee of appropriate PPE, and dedicated Covid-secure hospital wards.

"The statistics illustrate the significant impact that Covid-19 has had on the NHS in Wales, and on the lives of patients up and down the country, delaying treatments for so many," Dr David Bailey, chair BMA Welsh Council, said.

"What is vital now, is clear messaging for these patients, many of whom have, and continue to suffer due to these delays. Clear communication which provides insight as to where they are in the system, may offer a small amount of peace of mind. To have no information at all will be for many, extremely distressing.

"We welcome Welsh Government’s acknowledgement that extra investment will be needed, as this will be key in driving these figures down, but we do need urgent clarity on what exactly will be available and how it will be spent."