'Concerted action' needed to reduce NHS waiting times

“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”, commented Audit Wales' auditor general, Adrian Crompton.

“Concerted action needs to be taken on many different fronts, and some long-standing challenges need to be overcome.

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

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In February 2022, there were nearly 700,000 patients waiting for planned care which was double the amount for the corresponding period in 2020.

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

Withybush Hospital, Haverfordwest

The number of referrals for a first outpatient appointment has also fallen dramatically with 550,000 ‘potentially missing’ referrals still waiting to find their way back into the system.

The Welsh government made an extra £200 million available during 2021-2022 to help tackle the waiting times backlog, however the NHS bodies were unable to use this in its entirety.

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

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

Modelling carried out by Audit Wales shows that it could take at least seven years to return waiting lists to their pre-pandemic levels.

“Additional Welsh Government funding is going to be essential to tackle the backlog, but this, on its own, will not solve the problem,” says the report.

“The NHS also needs to overcome some 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."

Responding to the Auditor General’s report on the Planned Care Backlog in Wales, Darren Hughes, director of the Welsh NHS Confederation, said: “This report makes clear the enormous scale of the challenge ahead and we welcome the Auditor General’s recommendations.

"NHS leaders are all too aware that these are not just statistics, but individual people’s lives and experiences.

“The NHS has been through and continues to go through the most challenging period in its history.

"The effects of the pandemic won’t go away overnight and, despite leaders and staff doing all they can to deliver services for the people of Wales, it will take many years to reach a healthier position.

“The Welsh NHS Confederation has long called for a clear and sustainable long term funding strategy for health and social care.

"One-off, ring-fenced injections of cash that are time-limited do not allow the NHS to make the necessary long-term investments in staff and capital required to meet the needs of the people of Wales.

"Many NHS estates are not fit for purpose, requiring redesign and new equipment, which has major implications on the physical capacity of the NHS and its ability to make inroads in planned care backlogs.

“However, workforce is the number one limiting factor for NHS capacity. Without enough staff, the NHS is left with no option other than to think more creatively about how they deliver services.

"As the report points out, there is very limited private capacity to assist with tackling the planned care backlog.

“Recruiting and, as importantly, retaining exhausted staff, is a huge focus for NHS leaders.

"Improving wellbeing support for staff, upskilling and creating opportunities for more flexible working are all on the agenda, as are large scale recruitment strategies including international recruitment and widening access to careers in the NHS through programmes such as Kickstart.

“But these programmes and initiatives take time to have a tangible impact and we need to see things improve now to try to meet public expectation.

“Another key factor contributing to current pressures, alongside extremely high levels of demand, is the challenges facing social care.

"The sector is facing arguably more difficult workforce challenges than the NHS which is only being exacerbated by the tight labour market and the cost-of-living crisis.

"Without long term sustainable funding and impactful solutions in social care, the NHS will continue to experience problems discharging patients from hospital, hindering the NHS’ ability to address the planned care backlog.”