More than 1m people in England waiting for non-hospital care, leak reveals

While most of those waiting are adults, almost 300,0000 of them are children and young people who are seeking help with problems such as delayed development and long-term conditions.

The total number of people in England on the “hidden” waiting-list for care from community-based health services rose from 900,000 in January to 1.05m in May, the Health Service Journal reported. Some are facing delays as long as 120 weeks before they get help.

They are separate to the record 6.6 million people currently waiting for care in hospital, mainly surgery, for procedures such as a joint replacement or cataract removal.

The website obtained NHS England’s previously unpublished “community health services sitrep” analysis, which shows how the number of people waiting to access such services has soared by 35% since the organisation first published details of that waiting list in August last year.

The analysis shows that 321,000 adults in England are waiting for help, mainly physiotherapy, to tackle musculoskeletal problems such as back and knee pain. Another 120,000 on the list have foot problems and need care from podiatry services.

The 300,000 under-18s includes 74,300 who need speech and language therapy.

Siobhan Melia, chair of the community services network, warned that the inability of NHS community services to give people waiting for care as quickly as they would wish could lead to people becoming so ill that they seek help at A&E.

“Delays in accessing some services, including speech and language therapies, can have a lifelong impact, especially for children and young people,” she told HSJ.

“Long waits for services which help people to manage musculoskeletal conditions, such as lower back and neck pain, can make existing conditions worse, and mean that many people could ultimately attend [accident and emergency] in severe pain.”

The leaked document also disclosed that 514 hospital-based services which were suspended when Covid-19 hit in spring 2020 – almost a quarter of the total – are not yet back to full operation.

Across England 37% of children’s speech and language therapy services are still not at full pre-pandemic capacity. A majority of audiology (70%) and musculoskeletal (63%) services are in the same situation.

“These figures demonstrate what we’ve been warning about for some time – that the failure to fully reopen physiotherapy services is having an awful impact on patients,” said Prof Karen Middleton, the chief executive of the Chartered Society of Physiotherapy.

“The focus on waiting lists for surgery is understandable but those same lists could lengthen without urgent support for community services.

“These services tackle problems that if left untreated could seriously deteriorate and require surgery or other long-term interventions, so it’s essential for the system as a whole that we see immediate action.”

One NHS trust boss told HSJ that NHS England’s lack of focus on the fast-growing backlog in community care, compared with the huge efforts being made to tackle the 6.6m-stong waiting-list for acute care, was “immoral”.

Saffron Cordery, the acting chief executive of NHS Providers, said there was a “pattern of inequity” in NHS chiefs’ response to long waits for non-acute care, including for mental ill-health.

A Department of Health and Social Care spokesperson said: “We are working hard to tackle the Covid backlogs to ensure people get the support they need across a wide range of health services.”