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Record waiting times published - RCS warns the NHS faces a 'perfect storm' of winter pressures, Brexit and pensions crisis

10 Oct 2019

Professor Derek Alderson, President of the Royal College of Surgeons of England (RCS), has warned that NHS hospitals could face a ‘perfect storm’ of winter pressures, Brexit and the NHS pensions crisis, and urged the government to help the NHS get shipshape fast.

Although the government has launched a consultation aimed at alleviating the pensions problem, which has been exacerbating NHS waiting times, surgeons are concerned that any changes won’t come into force in time for the added pressure of the winter season. With the additional uncertainty of Brexit looming, the RCS is concerned the NHS could face its most difficult winter in recent memory.

The RCS has expressed these concerns as NHS performance data published today confirms the NHS has just come through one of its most difficult summers on record. ‘Referral to treatment’ statistics for August 2019 show that the number of patients waiting more than 18 weeks to start planned treatment was 662,053.  Only 85.0% were seen within 18 weeks, missing the government’s target of 92% again. By comparison, the number of patients waiting longer than 18 weeks for planned treatment in August 2018, was 530,374. At that time, 87.3% of patients were seen within 18 weeks. 

In August 2019, 260,887 patients waited over 6 months to start treatment, and over 45,000 people waited over 9 months. This is the first time the number of patients waiting over 9 months has exceeded 40,000. 

There were 1,233 patients waiting longer than a year in August 2019, an improvement on August 2018 when there were 3,405 patients waiting over a year. The waiting list size is estimated to be at 4.41 million by NHS England. 

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

“The NHS has had a difficult enough time dealing with winter pressures over the last few years. Throw into the mix the pensions crisis, which is leading many senior clinicians to cut back on extra work, and the uncertainty of how Brexit might affect the flow of medicines and medical devices coming into the UK, and the NHS could face a ‘perfect storm’ this winter. 

“Gone are the years where NHS hospitals had the staff and time to recover over the summer months in preparation for the busy winter period. Today’s performance figures show waiting times continued to deteriorate over the summer. We need swift and far-reaching government action to get the NHS shipshape for winter.

“It’s absolutely vital that the government brings forward a solution to the NHS pensions issue before the new year, to allow clinicians to take on extra work through the winter, without fear of unpredictable, crippling tax bills. Government also needs to set out a 5-year plan, including increased bed capacity and staffing, to get waiting lists under control in the longer term.”  


Notes to editors

1. Full data is available here:

2. 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.

3. For more information, please contact the RCS press office: telephone: 020 7869 6047; email:; out-of-hours media enquiries: 07966 486832.

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