NHS Surgery Delays in England – January 2023

NHS England Surgery Delays – What Is a Typical Waiting Time?

There is no denying that the NHS has gone through a particularly tough time in recent years – if not the toughest in its 75-year-history.

The Covid-19 pandemic led to increased service-strain and treatment delays, and while there are some measures in place to help clear the backlog, and ongoing debates about what more can be done to tackle this, it’s an issue that is set to remain for some time.

Of course, this is very stressful for the hard-working NHS staff, but also for those who are facing long waits for essential treatment.

In November 2021, we did research into typical surgery waiting times (for nine out of ten patients) at 50+ hospitals in England to see where patients could expect the shortest or longest delay.

Just over a year on (January 2023) we’ve refreshed that research to see if and how the situation has changed.

We’ve also run a survey with UK adults to find out how many are awaiting surgery, how many have opted to go private, and how those affected feel about the situation and their options.

Our Survey Findings

According to our recent survey of 2,382 UK adults, one in five (20%) of the respondents in England specifically told us they are on the waiting list for surgery with the NHS.

Of these, a quarter (25%) had been waiting a least a year, and one in six (17%) have had their procedure cancelled and no new date given.

The majority (56%) of those on the list said they are feeling frustrated, angry or upset about the delays they’ve faced, while around a third (37%) said is what they expected.

Around a quarter (26%) are exploring if they could get their surgery done privately in order to reduce their waiting time, and a further third (32%) would like to do this but can’t afford to.

Recent reports have revealed that some NHS Trusts are promoting private treatment, saying that it can offer a “quick and easy” way to jump the year-long queues, leading health experts to warn of the risk of creating a “two-tier” health service.

The Current Backlog for Surgery

The most recent NHS report (Oct 2022) indicates that there were 446,223 patients on the general surgery waiting list across England.

It said that half of patients were waiting fewer than 15 weeks – which is below the 18-week target set.

However, this does not tally up with the additional research we’ve conducted that looks at current waiting times for 9/10 patients, on a per-hospital basis.

Our research shows that while waiting times for general surgery procedures – which includes things like hernia repairs, stomach and gall bladder surgery and removal of the appendix – have gone down by six weeks since winter 2021 (from 57 weeks for 9/10 patients in November 2021 to 51 weeks in January 2023), none of the 52 hospitals we researched were currently meeting the 18-week referral to treatment target. In contrast, 4% were meeting this in November 2021.

It is a similar story with ‘other surgical services’ across England – which may include things like knee and hip replacements and hysterectomies.

In the latest NHS report, 428,876 people were waiting for a procedure that fell into the ‘other surgical services’ category.

It said that half of patients were waiting fewer than 13 weeks – however, again this does not tally up with the additional research we have conducted for 52 hospitals, which shows that 99% are not hitting the 18-week target for 9/10 patients.

General Surgery Delays

As mentioned, our research shows that there appears to have been some marginal improvements in general surgery waiting times in the last 14 months…

• Waiting Time in November 2021 (for 9/10 patients) *: 57.2 weeks
• Waiting Time in January 2023 (for 9/10 patients) *: 51.1 weeks
• Difference: 6.2 weeks less

*based on an average figure taken from a sample of 52 hospitals

That said, 51 weeks is still nearly a year’s delay – a timeframe that is bound to cause anxiety and stress for anyone – and there are some hospitals where this looks to be even longer.

While this is based on a sample of 52 hospitals across England, our analysis put Liverpool’s Aintree Hospital at the top of the table with a staggering 77-week general surgery wait time for 9/10 patients. It has improved very slightly though – from 78 weeks in November 2021.

While it currently has the shortest wait time of any of the 52 hospitals researched, the delay for general surgery at Newcastle’s Royal Victoria has actually increased by five weeks – from 18 weeks in November 2021 to 23 weeks in January 2023.

Overall, there is a 54-week (over a year) difference between the waiting times for general surgery at the top hospital (23 weeks – Newcastle’s Royal Victoria) and the bottom (77 weeks – Liverpool’s Aintree University) hospital.

Coventry’s University Hospital has managed to reduce its general surgery wait time by the most since we last ran this research –  dropping it by 29 weeks from 81 weeks in November 2021 to 52 weeks in January 2023. It is still almost three times the 18-weeks target though.

In contrast, Sheffield’s Northern General Hospital has seen the biggest increase in its general surgery wait time – adding 23 weeks onto the typical delay. In November 2021 the wait was 45 weeks for 9/10 patients, whereas it is sitting at 68 weeks in January 2023.

Hysterectomy Delays

While some improvements have been made with general surgery waiting times, the delay for those facing a hysterectomy has unfortunately gone up in the last 14 months…

• Waiting Time in November 2021 (for 9/10 patients) *: 42.1 weeks
• Waiting Time in January 2023 (for 9/10 patients) *: 48.2 weeks
• Difference: 6.1 weeks more

*based on an average figure taken from a sample of 52 hospitals

There is a 50-week (nearly a year) difference between the waiting times for hysterectomy procedures at the top hospital (23 weeks – Barnsley) and the bottom (73 weeks – Royal Preston) hospital.

And while it currently has the shortest wait time of any of the 52 hospitals we researched, the delay for hysterectomy surgery at Barnsley Hospital has actually increased by five weeks – from 18 weeks in November 2021 to 23 weeks in January 2023, pushing outside of the target time.

Norwich & Norfolk University Hospital has managed to reduce its hysterectomy surgery wait time by the most, by 11 weeks from 82 weeks in November 2021 to 71 weeks in January 2023. It is still almost four times the 18-weeks target though.

The Royal Preston Hospital has seen the biggest increase in its hysterectomy wait time – adding 24 weeks onto the delay. In November 2021 the wait was 49 weeks for 9/10 patients, whereas it is 73 weeks in January 2023.

Knee and Hip Surgery Delays

Orthopaedics – which include knee and hip replacement surgery – has seen some improvements (when looking at the overall view), with the typical wait time reducing by nearly 8 weeks for 9/10 patients.

• Waiting Time in November 2021 (for 9/10 patients) *: 58.3 weeks
• Waiting Time in January 2023 (for 9/10 patients) *: 50.6 weeks
• Difference: 7.7 weeks less

*based on an average figure taken from a sample of 52 hospitals

Our data showed that there is a massive 55-week (over a year) difference between the waiting times for orthopaedics surgery at the top hospital (30 weeks – London’s St George) and the bottom (85 weeks – Plymouth’s Derriford hospital).

And while it currently has the shortest wait time of any of the 52 hospitals researched, the delay for orthopaedics surgery at London’s St George hospital has actually increased by 2 weeks – from 28 weeks in November 2021 to 30 weeks in January 2023.

Bristol’s Royal Infirmary has managed to reduce its orthopaedics surgery wait time by the most, by 42 weeks from 93 weeks in November 2021 to 51 weeks in January 2023. It is still almost three times the 18-weeks target though.

Birmingham’s Queen Elizabeth Hospital has seen the biggest increase in its orthopaedics surgery wait time – adding 16 weeks onto the delay. In November 2021 the wait was 61 weeks for 9/10 patients, whereas it stands at a massive 77 weeks in January 2023.

Other Reports

According to the BMA (British Medical Association), NHS England data highlights the growing backlogs – with more patients than ever waiting for treatment.

The latest figures show a record high of more than seven million people waiting for treatment of some kind.

• 9 million patients are waiting over 18 weeks for treatment.
• Nearly half a million (411,000) patients have been waiting over a year for treatment.

It says that the number of outpatient attendances being carried out is still well below pre-pandemic levels, and while GPs can still refer patients, the pressure in hospitals means there is little capacity in secondary care, and those referrals are often being rejected.

The BMA is calling for immediate action to be taken to ensure that waiting lists don’t grow further.

They believe more funding is needed, alongside measures to retain the medical workforce, a credible plan to increase NHS hospital capacity without relying on the private sector, and increased measures to support effective collaboration between primary and secondary care.

Patient rights and options

If you’re on the list for NHS surgery in England, then it’s important to be aware of your rights and options.

If you’ve been referred for a physical or mental health condition, you have the legal right to start non-urgent consultant-led treatment within maximum waiting times – which is set at 18 weeks.

This right only applies to services commissioned by the NHS in England and does not include public health services commissioned by local authorities, maternity services, or non-consultant-led mental health services.

Your waiting time starts from when the hospital or service receives your referral letter, or when you book your first appointment through the NHS e-Referral Service.

Waiting times may vary between hospitals, and patients should consider this when choosing a hospital.  You can use the My Planned Care website to compare waiting times at different hospitals.

If the hospital or service cancels your operation at the last minute (on or after the day of admission) and for non-clinical reasons, they should offer another binding date within 28 days or fund your treatment at a date and hospital of your choice.

If you’re not offered an appointment within 28 days, you should complain to your local ICB using the NHS complaints procedure.

If your operation is cancelled before the day of admission, the hospital or service is not obliged to provide an alternative option within 28 days. However, your right to start consultant-led treatment within a maximum waiting time still stands.

Our conclusion

Sara Stanger, Head of Clinical Negligence (Liverpool) Been Let Down said:

“As the Prime Minister pledges to tackle NHS waiting lists in England, we welcome any increased government support for the health service in this time of crisis. However, many patients will still be facing uncertainty, particularly those that are currently caught up in the backlog.

It is essential that the challenges facing the NHS are addressed, as many patients have been left without the care that they need, and in some cases, this can have devastating effects. At a time where the country is also facing a cost-of-living crisis, private healthcare is not an option for everyone, and some patients will be left with little choice but to wait – even with the option of referring to another hospital.

Although it is reassuring to know that the NHS is high on the government’s agenda, many will be left wondering how exactly they plan to combat the waiting lists. Given the scale of this situation, it’s unlikely that any drastic improvements will be made overnight.

For patients, the current situation is undoubtedly worrying, whether you are waiting for routine treatment or if you require the ambulance service – there is a lot of uncertainty around how long it might take to receive the necessary care. It will be welcome news to people across England to know that this is a high priority but until we see evidence of changes in the waiting list figures, there may still be a level of concern.

The NHS and its staff work tirelessly around the clock to deliver the best care that they can but it’s essential that they are supported and provided with the resources that they need. We hope to see improvements over the coming months, supported by government initiatives and funding across the right areas. Ensuring that patients have the right access to care is crucial and although increased waiting times don’t always constitute negligence, this situation does bring to light just how important it is that the NHS has the government backing that it needs in order to improve standards.”

It’s clear that the situation remains critical, and urgent change is needed to ensure more patients can receive the surgery they need as quickly as possible.

While a delay to treatment is not necessarily a sign of medical negligence, if you believe that a medical professional has failed in their duty of care to you, and you suffer an injury as a result of this, then you could be entitled to compensation.

Further information can also be found on our medical negligence webpage.

How Been Let Down can help you

Been Let Down have a team of legal experts that specialise in medical negligence claims.

If you think you have been the victim of medical negligence and want to talk about the possibility of making a claim, you can make an enquiry online or get in touch with our expert team of clinical negligence solicitors.

You can make an online enquiry, request a callback at a time that suits you, or call us on 0800 234 3234. 

Our sources and methodology

Survey insight 

• A survey was run with 2,382 UK adults in January 2023.
• Data was split by respondent age, gender, region and country.
• Of these, 632 respondents were waiting for surgery with either the NHS or private providers.
• 534 were waiting for surgery with the NHS specifically.
• In addition, 104 of the 2,382 UK adults who completed the survey had recently had a surgery procedure done (either with the NHS or privately).
• Focusing on England specifically, 87% of the 2,382 respondents (2,080) were based in England.
• Of these, 414 (20%) were waiting for surgery with the NHS, 62 (3%) were waiting for surgery to be done privately and 83 (4%) have just had surgery done.

NHS Waiting Times Insight 

• https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2022-23/ (overall).
• https://www.nhs.uk/service-search/other-services/Procedures/Search (by hospital and surgery type).
• Data refers to time from GP referral in weeks – up to X weeks for 9/10 patients.
• Covers 52 hospitals in 39 towns / cities in England – not all hospitals and locations.
• Original data collected: 22nd-30th September 2021.
• Updated data collected: 16th-18th November 2021.
• Latest data collected: 6^th January 2023.
• All data refers to ENGLAND only – not Wales or Scotland.

Supporting insight 

• https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis
• https://www.nhs.uk/nhs-services/hospitals/guide-to-nhs-waiting-times-in-england/

Definition of General Surgery

• General surgery encompasses a broad range of surgery which includes surgical conditions of the gastrointestinal tract from the oesophagus to the anus. breast conditions. kidney, pancreas and liver transplantation, trauma to the abdomen and thorax.
• A few examples of procedures commonly performed by General Surgeons include hernia repair, stomach surgery, haemorrhoids, removal of the appendix, removal of the gall bladder, breast surgery, colonoscopy.