Period without strikes saw substantial progress on electives, provisional figures released by NHSE suggest

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NHSE claims 20% cut in long waiters before latest strikes

By James Illman 3 January 2024​

• Period without strikes saw substantial progress on electives, provisional figures released by NHSE suggest
• NHSE admits provisional data could have “significant issues regarding the quality” but says it is confident it is robust enough to forecast direction of travel of trends

Trusts reduced the number of 65-week breaches by around 20 per cent and cut the overall elective waiting list between October and mid-December, NHS England has said.

The claim is based on provisional data published by NHSE on 2 January, which came with a warning of possible “significant issues regarding the quality and completeness”.

The figures suggest the number of 65-week waiters fell from around 114,000 on 8 October to around 93,000 by 17 December. The last official “referral to treatment” figures were published last month (see table below). They reported there were around 107,000 65-week breaches in October.

Sources familiar with the provisional data, from the “waiting list minimum data set”, said while it was not as accurate as official referral to treatment statistics, it gives an accurate picture of the direction of travel and overall performance.

While senior officials admit they will miss their key elective recovery target of eliminating 65-week waiters by March, NHSE said the provisional figures, which are far more recent than the official statistics (which have a two-month lag) illustrated the progress trusts had made before the latest wave of strikes.

Progress will have then been significantly hampered by a three-day junior doctors strike before Christmas, and a further six-day walkout starting today, NHSE has said.

The provisional data also suggests the overall list reduced between October and mid-December – although some of the variation may be explained by data quality issues. The unvalidated data, which does not include figures from all trusts or activity being carried out by some private providers, suggests the list fell from 7.5 million in October to 7.2 million in December.

While the official RTT data shows there were in fact 7.7 million, not 7.5 million, pieces of activity on the overall RTT waiting list in October, sources said they expected the downward trend to be replicated in the validated numbers.

The provisional figures suggest the slight reduction of around 66,000 between September and October in the official RTT data, as reported by HSJ last month, could therefore have been replicated for November and December.

An NHSE spokesperson said: “During the break in industrial action… the total waiting list has been reduced by almost 200,000 patients and NHS teams have worked hard to ensure a 20 per cent reduction in the number waiting over 65 weeks.

“Six consecutive days of industrial action… represents the longest strike in NHS history and it will clearly have an impact on planned care over the festive period, adding to over 45 days already disrupted by industrial action to date – however, colleagues across the health service will be continuing to do their very best for patients and the NHS remains determined to reduce long waits further.”

Another major concern for system leaders is the growth in 78-week waiters – a cohort the NHS was meant to have eliminated by last April – but rose from 7,200 in June to 10,500 in October. The provisional data published on 2 January does not cover this cohort.

The data has drawn criticism from some experts however. Waiting list specialist and HSJ columnist Rob Findlay said: “NHSE is trying to ride two horses with this data, which on the one hand is not good enough to publish properly, and on the other hand is convenient to quote from selectively when it tells a story they like.”

Table: NHSE’s provisional figures from for 65-week breaches

Week-ending period	65-week breaches
08/10/23	113,863
15/10/23	112,659
22/10/23	113,122
29/10/23	111,633
05/11/23	110,291
12/11/23	107,944
19/11/23	106,324
26/11/23	102,857
03/12/23	95,970
10/12/23	95,475
17/12/23	92,661

Source: NHSE provisional data from ’waiting list minimum data set’

 

Source: NHSE RTT data