Problems within the NHS are only going to get worse, the Patients Association has warned, after a study showed that tens of thousands of people are being forced to wait more than 18 weeks for routine surgery.

A report entitled Feeling the Wait found that hospital trusts across England each cancelled an average of 753 operations on the day in 2015. Equipment shortages, a lack of beds and scheduling errors were the main reasons given to patients in such cases, the authors said.

The total number of procedures cancelled by individual trusts ranged from eight to 3,269.



The report said: “We have grown increasingly concerned at the waits patients are facing for surgery and the amount of patients who have had their operation cancelled on the day.

“There is a significant psychological burden on patients waiting to be given a date for surgery and for patients whose surgery has been cancelled (often on the day the surgery was due to take place).”

The study highlighted substantial increases in the number of patients waiting longer than 18 weeks for routine operations.

“This year’s report based on 2015 data shows that on the whole, waiting times are getting worse, not better,” the authors wrote.

The number of patients waiting more than 18 weeks for elective surgery, such as hip or knee operations, was 92,739 in 2015, compared with 51,388 in 2014, a rise of about 80%.

The report is based on responses to 112 freedom of information requests sent to NHS trusts across England.

The average waiting time for hip replacements, knee replacements, hernia surgery, adenoid surgery and tonsillectomies was longer than 100 days, the Patients Association said.

“The Patients Association has noticed a clear trend over recent years in the increasing time people are waiting for operations, as well as the number of people waiting longer for elective surgery,” said the association’s chief executive, Katherine Murphy.

“Every day we hear from the people behind these statistics on our national helpline: individuals who are in pain, worried they will lose further mobility, or will take longer to recover when they finally get their surgery. Their family members and carers are also having to share the added uncertainty and pressure faced by patients whilst they are waiting for their operations.

“Overall, with the significant jump in waiting times, we are very concerned that relaxing the rules on waiting time targets as recently reported will only exacerbate an already unacceptable situation for patients.

“From the patient’s perspective, nothing positive can come from taking away NHS targets – it just means people could be waiting even longer, as there will be little incentive for NHS providers to focus on efficiency.”

Liz McAnulty, a trustee of the Patients Association, told the BBC Radio 4 Today programme on Monday that the problems were not only due to funding issues.

“We need more money, definitely, we are about 10th in [the] league of EU countries, and we need more commitment to leadership, training and also for NHS England and NHS Improvement to sit down with patient groups, organisations such as the Kings Fund, and analyse what the problems are, and come up with a list of solutions and put it to the public, which may mean some radical changes,” she said.

“We need some honest and transparent discussion about what the problems are. We know they’re going to get worse, so let’s work together and arrest the downward slide for the NHS.”

Nick Hulme, the chief executive of Colchester Hospital University NHS foundation trust, said: “I think we should be very proud of the NHS of the significant improvement on waiting times over several years, but clearly there are huge pressures right across the NHS, in primary care, community, A&E, mental health, and what we’re looking at is a system that’s finding it difficult to cope with that increased demand, because we haven’t been able to radically redesign the NHS, whether it’s around elective planned care that we’re talking about, or other aspects of the NHS.

“It’s about making sure consultants are not spending time in follow-up appointments that aren’t necessary, that could be done by senior nurses and other qualified staff, making sure we protect our consultants in terms of their time so that they can provide the system only they can provide.

“It’s also a whole-system issue, it’s about working with primary care to make sure, for example, that we’re not wasting any first outpatient appointments and making sure people have had all their diagnostic tests before they turn up to see the consultant; that takes a whole step out of the process. It’s not about the financial situation, although clearly that is dire for all of us.”

In July, NHS officials in England announced that hospital trusts would no longer be fined for missing key targets on waiting times and cancer as part of an attempt to tackle the health service deficit.

National fines for missing targets have been scrapped for at least 12 months and replaced with individual trust plans aimed at improving performance and finances.

Hospitals will not face penalties for missing the four-hour A&E target, the 62-day target for cancer treatment or the 18-week goal for routine operations such as hip and knee replacements.

While there needed to be some sanctions, “the problem is that when the NHS trusts are paying all of these fines, that’s less money for patient care”, McAnulty said.

Hulme said he did not know any chief executive or senior management team in the NHS that made decisions based on whether or not the trust was going to be fined. “We’re all absolutely committed to deliver this promise to patients. It’s a perverse incentive that we’ve got parts of the NHS relying on financial balance, basically relying on patients getting poor care, so if it’s longer than 18 weeks, somebody makes a profit,” he said.

Health officials contested the report’s claim on the number of patients waiting more than 18 weeks for routine operations.

The health minister David Mowat said: “These claims are both unreliable and misleading. The latest official figures show that nine in 10 patients still wait less than 18 weeks for treatment, despite the fact that last year the NHS carried out 1.6m more operations than in 2010.”

“Fewer than 1% of operations were cancelled on short notice – stable despite this rising activity – and the number of people waiting more than a year has dropped by nearly 18,000 under this government.”

An NHS England spokesman said: “We have significant concerns about this report, which is both misleading and statistically flawed, and is based on a fundamental misunderstanding of the referral-to-treatment performance standard. Waits for an NHS operation remain close to an all-time low – down from a maximum wait of 18 months over a decade ago to 18 weeks now, with the average wait less than 10 weeks.

“Last month, more than nine out of 10 patients were waiting less than 18 weeks to start consultant-led treatment. We continue to make strides in cutting long waits, with the number of patients waiting over a year slashed from over 5,000 recorded in March 2012 to being in the hundreds now.

“In the last five years, since June 2011, the NHS has reduced the number of patients waiting more than a year for treatment by over 12,000.”