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Hospitals cancel 22,000 appointments every day as 6.8m wait to start treatment

Ambulance
Ambulance

Hospitals are cancelling more than 22,000 appointments every day despite the Government’s pledge to clear the NHS backlog, The Telegraph can reveal.

The average number of daily cancellations this year, so far, was up 20 per cent on pre-pandemic figures, when around 18,000 were axed every day.

Some patients’ appointments are being cancelled multiple times, the data, revealed through freedom of information requests to English hospital trusts, also shows.

In 2021, 30,267 appointments were cancelled five times or more, compared to 17,884 in 2019, an increase of 69 per cent.

Jeremy Hunt, former health secretary, said the numbers were “staggering” and warned that without a workforce plan, more appointments will be cancelled in the future.

Health Secretary Therese Coffey last week set out her “plan for patients” and promised to make progress reducing waiting times for care.

Some 6.8 million patients are currently waiting to start treatment, the highest on record, as of July.

“We expect backlogs to rise before they fall as more patients come forward for diagnosis and treatment after the pandemic,” Ms Coffey said.

The previous two health secretaries also pledged to cut the backlog of waiting patients. Sajid Javid, who resigned as health secretary in July, said he was “determined to do everything I can to ensure patients get the treatment they need when they need it”.

While his successor, Steve Barclay, said clearing the Covid backlogs was a “key priority”.

One in 10 appointments cancelled

Official figures released by NHS Digital this week from all NHS trusts in England show one in 10 (9.5 per cent) appointments, 11.6 million, were cancelled by a hospital in 2021-22. In 2011-12, 6.3 per cent of appointments were cancelled (5.8 million).

Although there have been some improvements since 2020, the number of outpatient appointments carried in 2021-22 were still below pre-pandemic levels, 122.3 million compared to 124.9 million in 2019-20.

In February, NHS England published its plan to tackle record waiting lists, including a pledge to deliver 30 per cent more elective activity than before the pandemic by 2024-25.

But analysis of figures provided by 78 trusts, up to Aug 8 this year, indicate appointments are being cancelled at a significantly higher rate than before the pandemic.

On average, 22,178 appointments a day have been axed this year so far, compared to 18,334 in 2019.

Daily cancellations peaked in 2020 at 24,561, before dropping to 20,856 in 2021.

Increase in multiple appointment cancellations

Hospitals have also seen an increase in multiple appointment cancellations over the course of a patient’s treatment.

The number of appointments axed 10 or more times in 2021 increased by 50 per cent compared to 2019, rising from 900 to 1,325, but peaking at 1,469 in 2020, according to data submitted by 55 trusts.

Some trusts said appointments may be recorded as cancellations if the consultation is moved to a different part of the hospital or the patient is seen by a different clinician.

But patient groups warned multiple cancellations, delays and changes to appointments can cause “distress and frustration” and “feed into patients’ sense of being abandoned by the NHS”.

‘I just burst into tears’

Kathleen Lipinski, 65, from Welwyn Garden City, Hertfordshire, said she broke down in tears after her cancer scan was cancelled for the second time this summer.

The retired social worker, who has skin cancer, underwent two weeks of radiotherapy at University College London Hospitals Trust (UCLH) and needed a positron emission tomography (PET) scan to determine if the treatment had worked.

As she arrived at the hospital on Jul 26 for the appointment she received a call to say it had been cancelled.

“They said ‘our scanner has gone wrong, there’s nothing we can do’,” she told The Telegraph. She was given another appointment a month later, which was again cancelled at the last minute as she was on her way to the hospital.

Kathleen Lipinski
Kathleen Lipinski

Ms Lipinski, who uses a wheelchair after losing her leg to bone cancer 10 years ago, said: “I just burst into tears.” After unsuccessful attempts to book the scan privately, she eventually had the appointment at UCLH – eight weeks after the original date.

If it was not for her daughter’s persistence, she said she would have given up trying to get the scan entirely. A UCLH spokesman apologised for the distress caused and said the cancellations “were issues with the machine which were outside of our control”.

‘We urgently need a workforce plan’

Mr Hunt said: “Such a staggering number of cancellations is largely down to one thing – a shortage of staff. We urgently need a workforce plan that addresses this because without more doctors and nurses even more appointments will be cancelled in the future.”

Jeremy Hunt - JESSICA TAYLOR/AFP
Jeremy Hunt - JESSICA TAYLOR/AFP

A survey by the Patients’ Association found more than a quarter (27 per cent) of patients had an appointment cancelled in 2021. Investigative and diagnostic procedures, as well as consultations about ongoing care, were most commonly delayed or cancelled.

Rachel Power, chief executive of the charity, said: “Although it’s not possible to tell what type of appointment is being cancelled from these figures, delays and cancellations feed into patients’ sense of being abandoned by the NHS, which has been building since the start of the pandemic when so many services that patients relied on were closed to them.

“I can only imagine the distress and frustration for those patients whose appointments have been cancelled multiple times.”

An NHS spokesman said: “The NHS is under considerable pressure with continued high demand for services and staff dealing with more patients with Covid in hospital this summer than the previous two combined, but it is important that appointments are only cancelled when absolutely necessary.”

A Department for Health and Social Care spokesman said the Government was making progress in reducing the backlog.

“But we know there is more to do, and we are working with NHS England to build additional capacity in hospitals by recruiting 50,000 more nurses by 2024, and are opening up to 160 community diagnostic centres across the country – 92 of which are already open and have delivered 1.9 million additional checks – in addition to the 92 surgical hubs already open to help diagnose and treat patients more quickly,” they added.