Some 27,834 patients in England who received inpatient treatment in May 2011 had waited more than 18 weeks since being referred by their GP. Photograph: Graham TurnerThe number of patients not being treated within recommended NHS waiting times has soared by a third since the coalition came to power, new official figures revealed.
A total of 27,834 patients in England who received inpatient treatment in May 2011 had waited more than 18 weeks for it since being referred by their GP, compared to 20,504 in May 2010 – a year-on-year rise of 33.5%.
That is higher than the year-on-year rise between April 2010 and April 2011, when it was 24%.
The Department of Health (DH) admitted that while 1.8% of outpatients in May 2010 were not treated within 18 weeks, that had risen to 2.3% in May 2011. Similarly, the proportion of inpatients who had to wait longer than expected to undergo surgery or some other treatment also rose over the same period, from 7.1% to 9.2%.
The deterioration in this measure of NHS performance casts further doubt on David Cameron's repeated pledges to keep NHS waiting times low, especially the 18-week Referral To Treatment (RTT) target. He last month made that one of his five personal pledges to voters on the NHS.
The monthly RTT data are significant because they show that the number of patients not treated inside 18 weeks has drifted upwards since the coalition came in.
Groups of doctors and Labour are likely to seize on the figures as evidence that the tight financial climate in the NHS means it is struggling to cope with rising demand for its services.
One of Andrew Lansley's first key decisions after becoming health secretary last year was that the NHS should stop central monitoring of whether the 18-week target was being met. But the prime minister recently in effect reinstated it when he stressed that he appreciated how important it was for patients and their relatives not to face undue waits for treatment.
The data comes a week after it emerged that the NHS's deputy chief executive, David Flory, wrote to all NHS organisations in England on 30 June criticising "unacceptable" RTT performance in February and March. Some 47 organisations had failed to meet the standard for treating 90% of inpatients within 18 weeks and 12 of them had also not treated the required 95% of outpatients within that time, Flory said, before warning the service that strong measures would be taken if RTT failings were repeated.
The statistics show that the overall proportion of patients waiting longer than 18 weeks for inpatient treatment by an NHS trust dropped month-on-month, from 10.2% to 9.9%. But wait times are usually shorter in May than in April.
The DH stressed that most patients were treated this May within 18 weeks and that waiting times had been "low and stable" over the past year. "The vast majority of patients were referred to treatment within 18 weeks: 90.8% of hospital inpatients and 97.7% of outpatients started treatment in 18 weeks or under from referral," said a spokeswoman.
"Monthly figures do fluctuate but remain low: the average waiting times for admitted patients being treated was 8.4 weeks in May 2010 and is 8.4 weeks in May 2011.
"The proportion of those patients not seen within 18 weeks remains low: 2.3% of outpatients waiting more than 18 weeks compared to 1.8% in May 2010, and 9.2% of inpatients waiting more than 18 weeks compared to 7.1%. in May 2010," added the spokeswoman.
Lansley said: "We are determined to keep waiting times low. The first full year of NHS waiting time data under this government confirms that the proportion of patients who wait longer than 18 weeks for treatment remains low and stable. Average waiting times from referral to treatment are at the same levels as last year. This is against a backdrop of rising demand for NHS services, so the low waiting times are a testimony to the hard work of NHS staff."
Some 276,531 patients were treated this May, compared to 274,713 a year earlier.
On the rising number and proprtion of patients not treated within 18 weeks the DH spokeswoman added: "With regards to why there has been an increase in the number of people waiting longer than 18 weeks, firstly it is important to note that while the percentages fluctuate, they remain low. Furthermore, there are more people than ever before in the healthcare system and demand is increasing.
"There will always be some longer waits reported – including as a result of clinical decisions, patients missing appointments and patients exercising choice. Where appropriate, we have given clinicians the freedom to treat the patients in the most need first, even if it means there is a risk of others waiting a little longer."
As well as the growing numbers of patients not being treated within 18 weeks, the same situation is emerging in four other key NHS waiting time target areas: treatment within four hours of arrival in A&E; access to a diagnostic test within six weeks; and receiving cancer treatment within either 31 or 62 days.
Doctors warned that the rising numbers waiting longer than they should for treatment could distress patients, affect their chances of making a good recovery and showed the NHS is "creaking at the seams" under growing financial strain.
Dr Richard Vautrey, deputy chairman of the British Medical Association's GPs committee, said: "As well as the obvious distress, both emotional and physical, caused to patients by increased waiting times, there are serious clinical issues. There are many situations where the longer a patient waits for the treatment they need, the less likely the chances of the treatment being effective. The NHS is coping with both massive financial pressures, and a huge reorganisation.
There was always going to be an impact on front-line care – the big question is how we can minimise the impact on patients."
Sir Richard Thompson, president of the Royal College of Physicians, which represents hospital doctors, said: "The apparent rise in waiting lists is both worrying for patients and evidence of an underlying cause – the increasing pressures on the NHS in general. The NHS is now creaking at the seams, with a growing number of patients needing urgent care, including older people with multiple health problems. Our members are finding it difficult to cope with the increased demand for urgent care, and this has a knock-on effect on the ability of hospitals to cope with planned diagnostic tests, medical procedures and surgical operations. Waiting lists could be the first indication that the NHS is not coping with effects of this inexorable rise in demand."
John Healey, the shadow health secretary, said the data was proof that improvements in healthcare were being reversed under the coalition. "David Cameron has pledged to keep waiting times low but these new official figures show that when compared with same period a year ago almost 7,000 more people were waiting longer than 18 weeks to get hospital treatment. That's a third up on last year and the situation is getting worse by the month. It is clear that people can't trust David Cameron to keep his NHS promises. The NHS is starting to go backwards again under the Tories. Instead of concentrating efforts on improving services for patients, ministers have spent a wasted year forcing through their reckless and damaging NHS reorganisation."
The waiting times news came as a new report on NHS performance by the King's Fund thinktank found that around half of England's hospitals may fail to make the big efficiency savings expected by ministers.
A survey of finance directors at 29 NHS trusts showed that, while organisations are meant to be making 4% productivity gains, 13 of the 29 have to save 6% or more of their budget. In eight of those the finance directors said they were uncertain that they could do so, while three said they expected their trust to end the financial year in deficit.
John Appleby, the King's Fund's chief economist, said the results indicated that with many trusts facing "very tough cost improvement targets … there must be a significant doubt about whether many of these targets will be met".
The NHS has been told to improve its productivity in order to save ?20bn by 2015 to cope with the ageing population and increasing numbers of people with a long-term condition.
Most of the finance directors believed patient care would not suffer in the short term. "But in the longer term, if the NHS can't find the productivity improvements needed, something will have to give because there is no more money to meet rising demand for services. This could have implications for patient care including longer waiting times or cuts to services," Appleby added.
The Department of Health said the thinktank should not "talk down the NHS on the basis of one snapshot study".
Professor Chris Ham, the fund's chief executive, is a member of Number 10's "kitchen cabinet" of health experts who offer advice on NHS policy.
Meanwhile, the abolition of the NHS's main public health body, the Health Protection Agency (HPA), has been delayed by nearly a year to reduce the risks of making large-scale changes around the time of the Olympic Games, the government said on Thursday.
The HPA was due to be axed in July 2012, weeks before the games, as part of a huge shakeup in public health.
• This story was updated on Friday to include the embargoed King's Fund thinktank survey
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