NHS staff deliver performance improvements despite record demand

The NHS exceeded its faster diagnosis cancer target for the first time in February amid record demand, according to new figures.

Thanks to the hard work of NHS staff, almost four fifths (78.1%) of people received a definitive cancer diagnosis or all clear within four weeks – with almost 200,000 (199,659) patients getting the answer they need within 28 days.

Monthly statistics show A&E departments reported that March was the busiest month ever with 2.35 million attendances, 8.6% higher than the number of attendances in March 2023 (2.17 million). There were over 560,000 emergency admissions in March, 6.6% higher than the same month last year (532,000).  

It was the busiest ever year for A&E services, with figures showing 26.2 million patients coming through the hospital front door (April – March), up 5.7% on 24.8 million pre-pandemic (year to March 2019). Emergency admissions for the year to March are up 6.4% on the preceding 12-month period.

Despite this significant pressure, and thanks to local staff delivering the improvements set out in the NHS urgent and emergency care recovery plan, there have been improvements in performance with 74.2% of attendances spending less than four hours in A&E departments last month – up from 71.5% last March. 

Performance data also shows that ambulance response times in March improved across all categories, with most serious callouts receiving a response in an average of 8m 20s, down from 8m 49s a year ago despite higher demand – 6% more incidents than in March 2023.

It was the busiest March for Category 2 callouts since March 2020, and response times were still two minutes faster than the month before despite busier services (399,850 in March vs 374,807 in Feb).

Progress comes on the back of robust winter planning and the NHS's urgent and emergency care recovery plan, which has seen more beds, new ambulances, and the rollout of measures such as care traffic control centres, urgent community response teams and same day emergency care.

The waiting list in February was 7.54 million, made up of an estimated 6.29 million patients because some are waiting for more than one treatment. Despite five days of industrial action in February, the NHS delivered 1.48 million treatments, 9% more than the same month before the pandemic (1.35 million in Feb 2019).

Changes were made to the way community paediatric waits were reported this month, moving them to the community health services dataset, removing around 36,000 pathways from the total waiting list. With this change considered, the waiting list in February remained stable compared to the month before.

Last month, for the first time, the NHS published analysis of the direct impact of industrial action on the waiting list, estimating it would be around 430,000 lower without the long period of strike disruption since December 2022, and that 157,127 treatments would have avoided waits of more than 65 weeks have been impacted.

Given this impact, last month the NHS announced that it was pushing back its target to virtually eliminate waits of 65 weeks from March to September at the latest. However, separate waiting list data for March shows the considerable progress NHS staff have still made in bringing down the longest waits for care.

Thanks to the elective recovery plan measures, number of patients waiting more than 65 weeks for treatment was 75,004 at the end of February, down from 92,213 (19%) in January and down by 68% from a peak of 233,051 in June 2021. Additional management data published this month suggests there was a further reduction between February and March, with 50,448 patients waiting more than 65 weeks for treatment as of the end of last month.

Since April 2023, more than 3.7 million people who would otherwise have breached 65 weeks have been treated to get to this point.

The NHS blueprint for recovering elective care set out to reduce the longest waits for patients, with surgical hubs and Super Saturdays playing a key part.

Over three quarters of the remaining 65-week waits are concentrated in 39 trusts, with 7% of providers having completely eliminated these waits and a further 13% having 10 or fewer patients waiting this long.

Waits longer than 18 months for treatment had fallen to 9,969 at the end of February, down 29% from 14,013 in January and down by 92% from a peak of 124,911 in September 2021. Again, the additional management data suggests a further reduction between February and March, with 5,049 patients waiting this long as of the end of March.

February saw a record number of diagnostic tests and checks delivered for that month– 2.24 million – with the proportion of patients waiting more than six weeks (20.8%) now the lowest it has been since March 2020, ensuring more tests are being delivered and at a faster pace.

NHS national medical director, Professor Sir Stephen Powis, said: “Today's data demonstrates once again how the NHS is working flat out to recover services and bring down waiting times for patients, despite enormous demand on services with more people than ever before attending A&E in the last year, over a million more than before the pandemic.

“For the first time ever, the NHS exceeded its faster diagnosis standard target for cancer with almost four in five patients getting a diagnosis or all clear within four weeks, which comes alongside significant reductions in the longest waits for planned hospital treatment and welcome improvements in both ambulance response times and the proportion of patients seen within four hours in A&E.

“We know that industrial action has had a significant impact on our elective recovery, but it is testament to the innovation and hard work of staff that 78-week waits are now down 96% on the peak and 65-week waits are down by over 70%, with three quarters of the remaining waits concentrated at just 39 trusts.

“So there is further to go and our ambitious recovery work continues, but it is clear the NHS is treating more patients more quickly and we have announced new ambitions for this financial year to build on the improvements made so far.”