People living in the poorest areas waiting longer for hospital treatment

The King’s Fund and Healthwatch England jointly call for urgent action to address hospital waiting lists and improve patients’ experience of delays to treatment
GP sitting opposite a patient about to take their tempreature

New analysis from The King’s Fund shows that people living in the most deprived areas in England are nearly twice as likely to experience a wait of over one year for hospital care than those in the most affluent. This includes people waiting for planned hospital treatment such as knee and hip replacements, cataract surgery and other common procedures.  

It shows that more than seven per cent of patients on waiting lists in the most deprived areas of the country have been waiting a year or more for treatment compared to around four per cent of those in the least deprived.    

With a record 5.6 million people across the country currently waiting for hospital treatment, the analysis also shows that waiting lists are growing more quickly in deprived areas. From April 2020 to July 2021 waiting lists have on average grown by 55 per cent in the most deprived parts of the country compared to 36 per cent in the least deprived areas. 

This trend suggests that people feel safer about coming forward for treatment and are being referred for the care they need. However, the disparities in waiting times uncovered by The King's Fund are a significant concern on top of the impact of the pandemic which hit the most deprived communities hardest.  

The impact on people's health and wellbeing

Our national poll of over 1,600 British adults who are currently waiting for planned treatment or who have a relative who is waiting suggests delays to treatment can take a toll on their health and wellbeing.  

We found nearly half of the respondents (46%) said they or their relatives didn’t receive enough information, or any at all, about when they can expect their treatment. Similarly, 48% didn’t receive any support to manage their condition during their wait, while 64% had not been given a contact they could turn to while waiting for treatment.   

It also found:  

  • Over half (57%) of those whose treatment got delayed agreed that this was taking a toll on the level of pain they faced. 
  • 54% agreed their mental health had been affected. 
  • 53% said their ability to carry out household tasks had been affected. 
  • 42% felt that their ability to work had been affected.  
  • Nearly one in five people, 18%, have already gone private for treatment or are considering it. 
  • Going private wasn’t an option for nearly one in two (47%) respondents who had their treatment delayed. 
  • Over half of the respondents (57%) said they or their relatives would be willing to travel to receive treatment if it reduced their waiting time. 
  • One in five would be willing to travel if the NHS offered support, such as accommodation (10%) and transport (10%). 
I feel mentally and physically exhausted – I can barely walk and take my children to school as pain is always worse in the morning. As I’ve been unsupported medically, and I don’t know how serious the illness is.
— Toby, 42, has been waiting for referral to rheumatology department well over a year

How to improve people's experiences of waiting

Healthwatch England's recommendations for NHS England based on your feedback:

  • Provide personalised, clear, accurate and consistent communication to people waiting for NHS treatment, consultation and surgery, including where they are on the waiting list. 

  • Keep people informed about the next steps for their treatment. 

  • Provide a point of contact for people on waiting lists to turn to for advice and support.

  • Put in place interim support, such as physiotherapy, pain relief and mental health support.

  • Put in place a system to better manage waiting lists, with a focus on diagnostics to identify what is wrong and better prioritise urgent treatment.

  • Re-prioritise treatment if people’s needs change. 

Are you one of the 5 million people waiting for treatment?

We know that not everyone is getting the help they need while they wait for care. That’s why we’ve launched a national survey to understand your experiences.  

Everything you tell us is confidential and will help us and the NHS understand what needs to be put in place to better support people like you.

So whether it’s gynaecological surgery, a knee replacement or a biopsy you’re waiting for, if you’ve got a story to tell, we want to hear it. 

Share Your Views

Sir Robert Francis QC, Chair of Healthwatch England, said: 

“With healthcare services forced to prioritise critically ill patients throughout the pandemic, it is a reality that people will be waiting longer for hospital treatment for a while.   

"However, NHS England must manage waiting lists better by reducing the risks and inconvenience to patients caused by delays to care, as part of the national action to reduce the backlog.  

“People need clear and individualised information from the NHS, such as what the next steps for their treatment or care will be and how long they can expect to wait. They also need to have easy ways to update the NHS about changes in their condition. With more emphasis on interim support, such as physiotherapy, pain relief and mental health support, we can make the experience of waiting more bearable and get people ready for surgery.  Managing delays should not be a one-off transaction. People need an ongoing relationship which minimises the risks and stress of waiting. 

“The extra investment into elective care should be welcomed, but we won’t tackle the backlog overnight. As millions continue to wait for treatment, we can take steps to give people confidence they haven’t been forgotten, which is critical when you’ve been suffering in silence for months.” 

Siva Anandaciva, Chief Analyst at The King’s Fund said: 

‘Waits for hospital treatment were already rising before Covid-19. But the pandemic has pushed NHS waiting lists to record levels and laid bare the deep health inequalities in our country.  

“It is not a surprise that waits for NHS care vary across the country but the fact that patients in deprived areas are nearly twice as likely to wait a year or more for planned treatment should be a wake-up call for a government that has committed to levelling up the country, and ring alarm bells for MPs in ‘red wall’ constituencies.  

“The government’s forthcoming plan to tackle the backlog of care must include a strong focus on tackling health inequalities and avoid a one-size fits all approach, otherwise there is a real risk that patients from our most deprived communities will continue to wait the longest for the treatment they need.’ 

About the poll

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 6248 adults, of whom 1,675 were waiting for planned NHS treatment and/ or had relatives who were. Fieldwork was undertaken between 19th - 24th August 2021.

Do health and social care services know what you really think?

Share your ideas and experiences and help services hear what works, what doesn’t, and what you want from care in the future. 

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