More than 11 million people are stuck in a ‘hidden’ NHS backlog and need follow-up care, a study has found.
The health care system routinely releases headline statistics on how many patients wait each month for routine hospital care, such as hip surgery and cataract removal.
Currently the toll in England stands at a record high of 7.75 million – the equivalent of one in seven people.
However, it excludes those who have already undergone a procedure and need an essential check-up.
Analysis by the reform think tank, based on freedom of information revelations, suggests there are 11.36 million patients in this queue – or one in five people. It suggests the total NHS backlog is actually 19.1 million.
MailOnline’s interactive tool allows you to see the queue at your local councillor, although only half of people in England have shared the data.
The think tank found that the waiting list for follow-up treatments has grown significantly since the pandemic. It is estimated that more than 11 million patients are waiting for continuing care – approximately 3.5 million more people than the elective backlog
While each trust has an average of 100,00 people on their ‘hidden’ list, the length of this queue varies dramatically between hospitals.
One reported that just 1,000 Britons required aftercare, while the worst-hit trust had a queue of more than half a million people.
The figures show 516,919 patients are queuing for a follow-up appointment at East Kent Hospitals University NHS Foundation Trust – the largest total.
Meanwhile, the ‘hidden’ backlog stands at 432,396 at Northumbria Healthcare NHS Foundation Trust, 403,108 at Guy’s and St Thomas’ NHS Foundation Trust in London and 238,382 at Cambridge University Hospitals NHS Foundation Trust.
North Midlands University Hospitals (201,372), Hull University Teaching Hospitals (195,035) and Mid and South Essex NHS Foundation Trust (167,352) also reported some of the largest waiting lists.
At the other end of the scale, just 1,008 patients in Nottingham University Hospitals are waiting for follow-up appointments – the smallest queue in the country.
The Princess Alexandra Hospital NHS Trust in Harlow (12,042), Harrogate and District NHS Foundation Trust (13,618) and North Cumbria Integrated Care (13,905) were also among the trusts with the smallest queues.
However, almost half of trusts in England – 47 percent – failed to provide data on their follow-up waiting lists.
Some 62 trusts provided data, 17 did not respond to the FOI request despite a legal duty to do so, and 39 claimed not to possess the information.
It means that the actual size of the ‘hidden’ waiting list will be much higher.
Experts warn that patients at this disadvantage are at risk of neglect and harm as health leaders prioritize higher profile cases.
Each case requires the attention of overworked NHS staff, who may be deployed to treat new patients or monitor existing patients.
Failure to adequately monitor long-term conditions or cancer patients, failure to manage medications and failure to monitor patients after surgery poses significant clinical risks, experts say.
The number of people waiting for follow-up care increased by 50 percent between May 2019 (7.53 million), before the pandemic, and May this year.
Rishi Sunak has made tackling the overall backlog in elective care one of his five priorities as Prime Minister.
Sebastian Rees, senior research and co-author of the report at Reform, said: ‘Patients’ health and safety are threatened by these hidden waiting lists.
‘If follow-up appointments are not arranged on time, there is a risk that cancer recurrence or complications after surgery will go undetected, and people will become disabled due to a worsening condition.
‘It is deeply concerning that so many trusts cannot even tell us how many people are on their follow-up waiting lists, which shows a lack of priorities or understanding of the problem.
‘NHS England must require all trusts to report this data and hold hospitals accountable for tackling this hidden backlog.’
Ophthalmology has the highest number of waiters, with a 28.5 percent increase from 2019 to 2023, the data shows.
The widening backlog in England stood at 7.75 million in August – the equivalent of one in seven people. This includes nearly 400,000 people stuck in the system for more than a year, often in pain
Under the NHS Constitution, at least 92 percent of patients must receive elective treatment within 18 weeks of initial referral (pink line). September 2015 was the last time this standard was met. NHS data for July shows that fewer than six in ten patients were seen within this time frame
The graph shows the top ten treatment areas with the largest follow-up backlog in 2023. Most patients are waiting for a check-up appointment in ophthalmology, cardiology or orthopedics
The Royal College of Ophthalmologists has previously warned that permanent damage from avoidable vision loss is nine times more likely in follow-up patients than in new patients.
Rachel Power, chief executive of the Patient Association, described the research as ‘alarming’.
She added: ‘We are concerned that long waits could lead to patients’ health deteriorating, perhaps to the point where treatment is no longer effective.
‘We urge the NHS to be transparent about the number of patients waiting for care.’
Saffron Cordery, deputy chief executive of NHS Providers, which represents NHS trusts, said: ‘No trust leader wants patients – their first priority – to have to wait for the care they need.
‘It is important to note that while the waiting list for follow-up appointments is concerning, many people on that list do not require urgent treatment or care.
‘Trusts work extremely hard to see patients as quickly as possible.’
Rory Deighton, director of the Acute Network at the NHS Confederation, which represents healthcare organisations, said: ‘Health leaders and their teams are doing everything they can to get the NHS back on its feet and reduce waiting lists despite serious challenges, but with industrial action that continue to hinder recovery efforts need more help to do so.”