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Patient numbers plummet as COVID ‘hollows out’ NHS

11 Jun 2020

Figures released by NHS England this morning show 239,088 fewer ‘admitted pathways’ were completed in the NHS in April 2020 than in the same month last year – a drop of 85%.  It demonstrates that hundreds of thousands of people have been left waiting for treatment while the NHS responds to COVID-19.

The Royal College of Surgeons of England (RCS) today called on government to agree a ‘robust plan’ to address a ‘double-whammy backlog’ both of patients presently on the waiting list, and of those who have not yet been referred into the system.  1.16m more referrals were made in April 2019 than in the same month this year.

Additionally today’s waiting time statistics show:

  • The percentage of patients seen within 18 weeks has dropped again from 79.7% in March 2020 to 71.3% in April 2020 - this is the lowest proportion since April 2008.
  • The number of patients waiting over 18 weeks has now risen above 1 million - it was 1,132,602 in April (up from 860,309 in March), which is the highest number since January 2008.
  • Patients waiting more than six months increased by 45% from 359,716 in March 2020 to 521,951 in April 2020
  • Patients waiting more than nine months increased by 73% from 69,807 in March 2020 to 120,423 in April 2020
  • Patients waiting over 52 weeks increased by 256% from 3,097 in March 2020 to 11,042 in April 2020.

The RCS says an urgent commitment to maintaining additional capacity in the independent sector, keeping the Nightingale hospitals open, and reforming working practices to make best use of operating theatres, are all necessary if the system is to create enough “COVID-light” facilities where patients can be treated safely.

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

“The NHS has coped incredibly well with the immediate COVID crisis, but to do so it had to hollow out its routine, but essential, work to keep people well.

“Patients who have been waiting through the pandemic will very often have been in pain, and the longer some of them wait, the worse their conditions become.

“Elective operations cover not only essential orthopaedic work – giving relief to people in need of new hips, knees and other joints – but life-saving treatment for cancer, heart problems, and neurological disorders.

“It is going to be a herculean task to get through what we believe is a double whammy backlog.  There are those on the list already, and then thousands of patients who will come forward and be added to the list when the pandemic begins to abate.

“That means we need government support to keep as much capacity as possible in the NHS, including by continuing to have public contracts with the independent sector so that patients are seen because they need treatment, not because they can pay.”


Notes to editors

  1. The NHS England figures waiting times figures were published today at
  2. The figures show the total number of admitted pathways was 41,121 in April 2020,  compared to 280,209 admitted pathways in April 2019.  This represents 239,088 fewer admitted pathways in April 2020, compared to the same month last year – a drop of 85%. 
  3. Admitted pathways are the waiting times for patients whose treatment started during the reporting period and involved admission to hospital, including day cases. These are sometimes referred to as inpatient waiting times. They include the complete time waited from referral until start of inpatient treatment.
  4. The total number of new RTT periods (referrals) in April 2020 was only 491,934, compared to 1,656,081 in April 2019, representing 1,164,147 more referrals in the same month last year.
  5. NHS England paused collection of information on cancelled elective operations in April until May 14th, to free up resources for dealing with COVID-19.
  6. The Royal College of Surgeons of England has published a Surgical Recovery Plan and made detailed submissions about how the NHS should recover from the COVID crisis in its representations to the House of Commons Health and Social Care Committee.
  7. 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.
  8. For more information, please contact the RCS Press Office:

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