More than 11 million people who need follow-up care in hospital are currently on “hidden” NHS waiting lists, a study has found.
Experts warn that these patients – who represent a fifth of the population – are at risk of being neglected and harmed as health authorities prioritize high-profile cases.
The NHS publishes headlines each month showing how many people are waiting to start treatment, with a record 7.75 million.
Rishi Sunak has made tackling this backlog one of his five priorities as prime minister, but the count excludes those who have had a procedure such as a hip replacement or cataract removal and require essential examinations.
A new analysis from the reform think tank based on freedom of information disclosures shows that 11.36 million patients are waiting for follow-up appointments.
The think tank found that the waiting list for follow-up treatments has grown significantly since the pandemic. It is estimated that more than 11 million patients are waiting to continue treatment – about 3.5 million people more than the backlog of electives
The growing backlog in England reached 7.75 million in August – the equivalent of one in seven people. This includes nearly 400,000 people who have been stuck in the system for more than a year and are often in pain
This means that the “hidden” waiting list includes 3.6 million more patients than the elective waiting list, which totals 19.1 million.
Each requires the attention of overstretched NHS staff who may be deployed to treat new patients or monitor existing patients.
Failure to adequately monitor long-term disease or cancer patients, failure to take medications, and failure to monitor patients after surgery pose significant clinical risks.
The number of people waiting for follow-up care increased by 50 percent between May 2019, before the pandemic, and May this year.
Each trust has an average of 100,000 people on its “hidden” list, but one trust has more than half a million.
Almost half of trusts – 47 per cent – failed to provide data on their follow-up waiting lists.
Some 62 trusts provided data, 17 did not respond to the FOI request despite a legal obligation and 39 said they did not have the information.
Sebastian Rees, lead researcher and co-author of the report at Reform, said: “Patient health and safety are being put at risk by these hidden waiting lists.”
“If follow-up appointments are not arranged in time, there is a risk that cancer recurrences or complications after surgery will go undetected and people will become disabled due to a worsening of their condition.”
“It is very worrying that so many trusts cannot even tell us how many people are on their follow-up waiting lists, which suggests a lack of priority or understanding of the problem.”
“NHS England should require all trusts to report this data and hold hospitals to account for tackling this hidden backlog.”
The minimum and maximum waiting lists in 2023 differ drastically.
Although East Kent hospitals have double the number of outpatient referrals of Nottingham University Hospitals, indicating greater acute trust, their follow-up delay is 513 times that of Nottingham: 516,919 versus 1,008.
This suggests that some patients receive unacceptably poor quality care as a result of their consultant’s decision not to prioritize follow-up appointments or poor management of follow-up waiting lists.
Ophthalmology has the highest number of waiters, with an increase of 28.5 percent from 2019 to 2023, the data shows.
The Royal College of Ophthalmologists has previously warned that permanent damage from preventable vision loss is nine times more likely in subsequent patients than new patients.
Rachel Power, chief executive of the patients’ association, described the investigation as “disturbing”.
According to the NHS Constitution, at least 92 per cent of patients must receive elective treatment within 18 weeks of initial referral (pink line). This standard was last met in September 2015. NHS data for July shows that fewer than six in 10 patients were seen during the period
The graphic shows the top ten treatment areas with the largest follow-up backlog in 2023. Most patients are waiting for an examination appointment in ophthalmology, cardiology or orthopedics
She added: “We are concerned that long waiting times could cause patients’ health to deteriorate, possibly to the point where treatment is no longer effective.”
“We are calling on the NHS to be transparent about the number of patients waiting for treatment.”
Saffron Cordery, deputy chief executive of NHS Providers, which represents NHS trusts, said: “No trust leader wants patients – their top priority – to have to wait for the care they need.”
“It is important to note that while the waiting list for follow-up appointments is concerning, many people on this list do not require urgent treatment or care.”
“Trusts are working extremely hard to treat patients as quickly as possible.”
Rory Deighton, director of the acute network at the NHS Confederation, which represents healthcare organisations, said: “Health leaders and their teams are doing everything they can to get the NHS back on its feet and reduce waiting lists despite huge challenges, but with “Industrial.” Measures that continue to hamper recovery efforts need more help.”
An NHS spokesman said: “Appointments of this type do not form part of the elective treatment waiting list, they are routine follow-up appointments after treatment has been given and in many cases patients may be booked for multiple appointments.” Therefore, it is simply wrong to classify these appointments as Count Patients or to claim that all follow-up patients are waiting longer than necessary.
“Thanks to the hard work of staff, 87,000 more patients were treated in August than in the same month before the pandemic, while the NHS is also working to reduce the number of unnecessary appointments, with thousands of patients deciding they are not needed,” actually participate.’
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
