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
Man walking out of hospital

People living in deprived areas waiting longer

New analysis from The King’s Fund shows that people living in the most deprived areas in England are nearly twice (1.8 times) as likely to experience a wait of over one year for hospital care than those in the most affluent.  

The analysis looks at waiting lists 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 (latest available data), 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 this analysis 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

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

The poll, commissioned by Healthwatch England, 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. And 48% didn’t receive any support to manage their condition during their wait.

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 that their mental health had been affected; 53%, that their ability to carry out household tasks had been affected; and 42%, 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%, of the 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 as long as the NHS offered support such as accommodation (10%) and transport (10%). 

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.’

Sir Robert Francis, 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.” 

How to improve people's experiences of waiting

Healthwatch England has set out recommendations for NHS England based on public feedback it has already received:  

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

To help NHS services improve support for people while they wait for care, Healthwatch England has launched a survey to gather the publics ideas and experiences:

Take part in the survey

Case Study

Sybil Williams, 86, from Minehead waited for hip replacement surgery for 17 months, following referral to Musgrove hospital in October 2019. The surgery was to take place in spring 2020 but was delayed due to the outbreak of the pandemic. Sybil wasn’t told when she would have her treatment or was provided with any support as she waited in pain. 

Sybil, who is a retired nurse, said: “As I was waiting for my surgery, I would frequently call both the admissions department and the surgeon’s secretary to check on progress - as a reminder I was in pain.  

The waiting time was dreadful. I was in constant pain and at times thought I couldn’t go on any longer. I felt suicidal in December 2020.  

Due to my amputated leg, I use mobility aids to get around, but I developed a shoulder injury that was so painful I couldn’t move. I had lost a lot of my independence and had to turn to painkillers to ease my pain while waiting for surgery. 

When the day finally came, I felt extremely well looked after by the NHS. The surgery went very well too. I have now regained my independence and joy of life. You wouldn’t even know there had been anything wrong with that hip.” 

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