The worsening NHS waiting lists is a hot topic, from a patient outcome perspective as well as operationally and financially for the NHS, and of course politically.
The following are 3 key elements to consider when starting to understand the issue and identifying potential solutions:
- Overall number
The waiting list is currently 5.6m, a 32% increase since March 2020 and the first lockdown.

Source: NHS England Consultant-led Referral to Treatment Waiting Times
Those waiting for over 52 weeks have increased from 0.1% in March 2020 up to 5.1%.
2. The ‘real’ overall number
What’s not captured above? The impact of the ‘inflow’ – i.e. referrals. The number added to the waiting list dropped sharply in March 2020 (30% compared to March 2019) and only started to recover to pre-Covid levels in March 2021.
The reduction were due to several factors including changes in patients behaviour seeking medical input and genuine reductions in demand.
Comparing the number added to the waiting list between March 2020 and July 2021 (21.3m) with the monthly figures based on the 12 months before (28.7m), there are 7.4m potential extra patients to go on to the waiting list.
Of course not all of these will be ‘added back’ to above 5.6m – (out of those that did need treatment and didn’t or couldn’t access medical input) some will not need the treatment anymore, some will unfortunately have passed away and some will have sought treatment privately (20% of 4,000 people in a recent survey said they sought private treatment because they couldn’t get treatment on the NHS).
3. What type of need?

Source: NHS England Consultant-led Referral to Treatment Waiting Times
Reviewing the treatment functions reveals that 73% of the waiting list is comprised of the top 10 areas. Trauma & orthopaedics, Ophthalmology and ENT make up 30% of the list.
This provides further insights into the ‘type’ of capacity that needs to be available, ‘who’ (NHS versus other providers’ and ‘how’ (for example, dedicated centres focused on a particular area?) it should be delivered.
Very happy to hear your comments below or feel free to email me to share ideas – janak@usehealthdata.com