The NHS could be facing a huge rise in negligence claims due to the increase in wait times with more than 4.2 million patients now on waiting lists for surgery, which is a 55 per cent rise over the last five years, the National Audit Office (NAO) has warned.
These worrying signs of increased waiting times don’t look like slowing down anytime soon, with the number of patients waiting more than 18 weeks for an operation tripling over the same period –going from 153,000 in March 2013 to 528,000 in November 2018, forcing patients to wait longer as the NHS targets have repeatedly been missed.
It is estimated that around 40% of NHS compensation claims are already due to delays in treatment or diagnosis, but this has the chance of rising due to the longer waiting lists.
NHS England is currently reviewing the health service targets and could scrap the current 18-week target for people to begin their treatment following a referral.
The National Audit Office links the longer wait times to the lack of beds hospitals are now providing, warning that the NHS has lost 8,000 beds since 2010.
The Head of NHS England, Simon Stevens said in 2017 that waiting times would be on the increase as hospitals would be focusing on other areas, such as cancer and mental health.
The NHS long-term plan said that funds will be injected over the next five years to “grow the amount of planned surgery year-on-year, to cut long waits, and reduce the waiting list.”
But, the NAO study said patients could suffer harm from these growing lists.
They said: “There is a risk that longer waiting times may lead to patient harm and negligence claims against the NHS.
“For many people, longer waits result in inconvenience and the discomfort associated with living with a medical condition.
“But for others their condition may deteriorate and a longer wait for treatment may cause them harm.”
The report said that NHS do not provide in-depth analysis to show the extent of which patients harmed occurred as of a result of longer wait times.
“Given that 40% of clinical negligence claims are brought because of delays in diagnosis or treatment, there is a risk that longer waiting times may lead to an increasing number of future claims,” it said.
The NAO said that: “While there has been no explicit policy to deprioritise elective care, incentives for achieving waiting times standards for elective care have been weakened or removed over the past few years”.
The lack of beds also means: “trusts will treat emergency and cancer patients first due to the urgent nature of the treatment.”
The report said: “We found that bed occupancy has increased in recent years and an increasing number of trusts now routinely operate with a bed occupancy rate well above 90%.
“The number of beds in the NHS has reduced by 7% (8,000) since 2010-11.
“While reducing excess beds may create efficiencies, after a certain point the capacity constraints this will introduce will impact on other resources such as staff and theatre usage.”
If NHS England are wanting to hit their 18-week target again, they would need to make a “significant investment,” the report said.
They added: “We estimate that it would cost an extra £700 million to reduce the waiting list to the size last seen in March 2018, based on current trends.”
The Vice President of Royal College of Surgeons, Professor Neil Mortensen mentioned that people will be very concerned by the report.
“These will be patients waiting in pain or discomfort, possibly unable to work or go about their daily lives, and worried that their condition may deteriorate,” he said.
“They may also need extra help from family members and can begin to feel as if they are a burden.
“The fact that 40% of NHS compensation claims are attributed to delays in treatment and diagnosis is a visible sign that reducing waiting times needs to be an absolute priority.
“While the NHS long-term plan commendably sets out to strengthen community services, which should help ease pressure on hospitals, more needs to be done to properly tackle the backlog of patients waiting for surgery.”
Prof Mortensen said the college supports pilots to test new NHS targets but it is “important to acknowledge that altering targets will not solve the underlying challenges the NHS faces”.
An NHS spokesman commented to the NAO report: “The NAO is right to highlight improvements to NHS cancer care, which mean more people are surviving cancer than ever before, and that despite significant increases in demand, more people are getting quick tests and hospital treatment.
“As the additional funding to help deliver the NHS long-term plan becomes available from April, local health groups are being allocated the money they need to increase the amount of operations and other care they provide, to cut long waits.”
Whilst the wait times are increasingly poor, the head of NAO, Sir Amyas Morse mentioned how the NHS have made good progress in some areas, such as increasing the number of urgent cancer referrals.
“However, there has been insufficient progress on tackling or understanding the reasons behind the increasing number of patients now waiting longer for non-urgent care,” he said.