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Hospital admissions have dropped by over 84,000 this year, despite rising waiting lists

13 Sep 2018

There have been over 84,000 fewer NHS treatments, including surgical operations, performed by consultants so far this year compared to last year, analysis by the Royal College of Surgeons shows.

From January 2018 – July 2018, there were 2,054,655 hospital-based treatments carried out in the NHS by a consultant. This was 84,504 fewer than the same period in 2017, when the figure was 2,139,159. 

The average number of admissions each day (excluding bank holidays and weekends) dropped from 14,652 in January to July 2017, to 13,977 in January to July 2018, meaning there have been 675 fewer admissions each day so far this year. 

There was a decrease in the number of operations performed at the start of the year following advice from NHS England’s emergency pressures panel* (of which the RCS is a member) to postpone all planned surgery for NHS patients in January. However, analysis by the RCS shows that this decrease has continued well into the summer months, despite waiting lists for planned surgery growing. The RCS believes that the decrease in operations performed is due in part to the rising number of emergency admissions. 

Professor Derek Alderson, President of the Royal College of Surgeons, said:

“It’s no secret that the NHS faced one of its worst winters on record at the start of this year. NHS England’s advice to hospitals to cancel all elective operations in January was a necessary step given the circumstances.  This move freed up NHS hospital staff to deal with patients needing emergency treatment, and spared patients who were due to have surgery the trauma of having their operation cancelled on the day.

“However, this poor start to the year has left hospitals with the mammoth task of trying to catch-up on those operations, while waiting lists have continued grow.  Patients are being left waiting in pain and distress, with the potential for their conditions to deteriorate. 

“Over the summer months we would usually see a fall in the number of patients waiting for treatment. However, with 503,900 patients now waiting, lists are now at record levels. It’s these record waiting lists that make the drop in admissions concerning.

“With so many patients waiting, there is clearly plenty of work hospitals could be doing, yet significantly fewer patients have been admitted this year for consultant-led treatment.  Even with a drive for more non-consultant delivered care, these numbers do not add up.

“The fact is there are now too few hospital beds in the NHS to efficiently manage demand. Rising emergency admissions are also taking their toll. There has been no coordinated plan to catch-up the planned surgery backlog that was built-up in the winter months, and coupled with an under-resourced social care system, the NHS is now headed towards winter on a precariously shaky footing.

“We are supportive of plans to reinstate the National Escalation Pressures Panel announced last week, as this gives a voice to the clinicians on the ground, so that they can bring their expertise to winter planning.

“If the NHS is to peddle back from this challenging year, the Government’s 10-year plan will have to focus on reducing the number of long staying patients in hospital and building the capacity that is needed, so that patients can get the care they require when it is of most benefit.” 

Data published by NHS England today also shows 83.9% patients at major A&E departments (‘type 1 units’) were treated within the four-hour government target in August.

Furthermore, the data reveals that 87.8% patients were treated within 18 weeks to start planned treatment in July 2018 – well below the 92% government target.  Delayed days also increased between June and July 2018, from 134,326 to 139,983. 

*This has now been renamed the National Escalation Pressure Panel. 


Notes to editors

1. Averaged daily admissions for January – July: 

January – July Admissions per working day**
2018 13,977
2017 14,652
2016 14,559
2015 14,838
2014 14,936

**These figures exclude bank holidays and weekends.  

2. Total admissions for January – July:

January – July Total admissions 
2018 2,054,655
2017 2,139,159
2016  2,125,630
2015 2,181,249
2014  2,195,571

3. RTT waiting times and delayed days: 

   % within 18 weeks   Number waiting >18 weeks  Number waiting >52 weeks   Number waiting >26 weeks (6 months)  Number waiting >39 weeks (9 months)   Delayed days 
July 2018   87.8%  503,900   3,464   191,658  35,969  139,983
June 2018   87.8%  501,687  3,517  196,231  36,186  134,326
May 2018  88.1%  485,201  3,101  211,324  35,976   139,204
July 2017   89.9%  390,659  1,642  128,884  20,731  181,891

4. A&E waiting times: 

  Patients seen within 4 hours in type 1 units Patients seen within 4 hours in all units Type 1 attendances  Emergency admissions via type 1 
August 2018   83.9%  89.7%  1,252,793  382,926
July 2018  83.5%  89.3%  1,366,219   390,993
June 2018  85.6%  90.7%   1,308,356   377,165
August 2017   85.4%   90.3%   1,256,666   356,405

5. Full data set available here:

6. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

For more information, please contact the RCS Press Office: telephone: 020 7869 6047/6041; e-mail:; for out of hours media enquiries: 07966 486832.

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