Waiting lists have hit a new high in Wales with concerning figures also recorded for ambulance response times but the head of the NHS in Wales said she expects to see improvement soon.
Judith Paget spoke as the latest NHS data for October and November showed a record high number of NHS patients in Wales are waiting to start treatment after nine months of consecutive increases. Fewer than half of life-threatening 999 calls were also responded to within the eight-minute target time in November.
The number of patients waiting more than two years for treatment has also started increasing again, although it remains significantly lower than at the peak coming out of the pandemic.
In October the number of patient pathways increased from just over 801,300 to just over 802,100, the highest figure on record. The number of patient pathways is not the same as the number of individual patients, because some people are waiting for more than one medical treatment. For the latest Welsh news delivered to your inbox sign up to our newsletter
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Of the 802,100 patient pathways awaiting treatment in October there were about 620,300 individual patients, also the highest figure on record. This means more than half a million people in Wales are waiting to start treatment.
Comparatively in August there were around 760,300 patient pathways awaiting treatment, involving 583,000 individual people. The length of time these people are waiting differs depending on the treatment they are waiting for. The Welsh Government has a number of key targets in place relating to each department and how long people should be waiting.
For cancer services, there is a 62 day target for people to start treatment from the first point that they are first suspected of having cancer. In October 2,051 people started their first definitive treatment – 228 more than the previous month.
The number of pathways closed following the patient being informed they did not have cancer increased to 15,594. Performance improved against the 62 day target in October, increasing to 58.0%, compared to 55.0% the previous month.
Key points from the data:
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In November there were 5,949 red (life threatening) calls to the ambulance service, 16.4% of all calls. An average of 198 immediately life-threatening calls were made each day, the highest on record.
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47.6% of red calls received an emergency response within eight minutes. This was 2.8 percentage points lower than in October.
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In October the number of patient pathways waiting to start treatment increased from just over 801,300 to just over 802,100, the highest figure on record.
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In October, when there were just over 802,100 open patient pathways, there were about 620,300 individual patients on treatment waiting lists in Wales, the highest figure on record.
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The proportion of patient pathways waiting less than 26 weeks for treatment decreased to 54.0% in October.
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The number of pathways waiting longer than 36 weeks increased in October, to just under 280,500, the second highest figure on record.
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In October a little more than 24,200 patient pathways were waiting more than two years. This almost two thirds (65.6%) lower than the peak, but an increase from the previous month.
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The planned care recovery plan – to eliminate two year waits in most specialties by March 2023 – was not met in March 2023 and in October 2024 there were still a further 17 specialties with pathways waiting more than two years. This accounted for 3,181 pathways, which is a decrease of 23 compared to September.
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For diagnostic services, patient pathways waiting increased to just under 112,400 in October.
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For cancer services, 2,051 people started their first definitive treatment in October, 228 more than the previous month. The number of pathways closed following the patient being informed they did not have cancer increased to 15,594. Performance improved against the 62 day target in October, increasing to 58.0%, compared to 55.0% the previous month.
The response:
Judith Paget – Director General for Health and Social Services and the NHS Wales Chief Executive – took questions from WalesOnline about the figures. Here’s how she responded to some of the key points highlighted.
Ambulance response times to life-threatening calls
Responding to why fewer than half of life-threatening 999 calls were responded to within the target time in November, she said: “I think the figures for November are really interesting. And absolutely when you take the figures at face value you would think the percentage has reduced slightly.
“But there is some very important context here in that the life-threatening calls to the Welsh Ambulance service in November hit 6,000 calls in one month. The average is 198 calls per day. That is the highest call rate for red calls that we have got on record. So that’s a really important factor for those figures.
“I would also say that despite the performance percentage falling slightly, ambulances did respond to the highest number of calls within eight minutes this year. They actually got to 2,778 calls within eight minutes which is the highest number [of responses within the target time]. Although the percentage has gone down slightly, actually they responded to more calls and got there within the time.
“November has been a significantly challenging month for our urgent and emergency services because of the high numbers of respiratory illnesses that we’ve had circulating. We’ve seen RSV, covid, and then we’ve had flu, which seems to have come to us a little earlier this year than it might have traditionally. So it has been a really, really busy month.”
Patient waiting times increasing
Responding to why patient pathway waiting times have increased for the ninth month, she said: “The figures that have been published today relate to the position for October, and additional money provided by the cabinet secretary – the additional £50 million – had not been announced or allocated at that time.
“So these figures don’t reflect that additional investment. That money has now been allocated out to NHS organisations, to health boards in Wales. They have all confirmed their plans to ensure that over the next few months, certainly as we move up to the end of March, that they will be addressing those long-waiting patients. Particularly those patients who have waited more than two years.
“Based on the October data – 24,000 patients [waiting more than two years] at the moment – that figure has been coming down considerably. It is down about 65% since we came out of the pandemic. So the figure has been coming down, and this additional investment will mean we will be able to do additional activity now over the next couple of months.
“That will be a combination of our staff thankfully working additional hours or sessions or on weekends – and we are incredibly grateful to them – plus some outsourcing options with the private sector as well. Those have now started so all that money has now been deployed.
“In reality some of those patients [waiting more than two years in October – will already be benefiting from that. I was hearing yesterday that 3,800 patients from south east Wales who had been waiting for cataracts surgery had now had their letters informing them that they will have their surgery. So things are happening on the ground.
“Clearly there is a lag in the data so that won’t show in the performance figures until January at the earliest and then into February. The cabinet secretary and I met with health boards yesterday and they were describing the plans they had in place. By the end of March we think that 24,000 currently waiting for more than two years should be down to about 8,000.”
‘Confidence in delivery is high’
In an attempt to reassure anyone who is concerned by the figures she said: “The money has been allocated out and the plans are there. We’ve got confirmation from the NHS that they are able to use the [resources] to do exactly what we want, which is to reduce those long waiting times, and their level of confidence in delivery as we move through the last quarter of the year was high in conversations yesterday (Wednesday).
Shadow response
Regarding the figures James Evans MS – the new Welsh Conservative shadow cabinet secretary for health and social care – said: “Nowhere else is it clearer than in the Welsh NHS that Wales, under Labour, is broken.
“The Welsh Labour Government had promised not just reductions to the ever-growing list, but the elimination of the longest waits, of over two years, but they’ve broken their promise as patients continue to wait in pain for treatment.
“This situation is a crisis, but it isn’t beyond repair. The Welsh Conservatives will bring forward a plan to fix the Welsh NHS, to improve outcomes for patients and boost morale for staff.”