NHS Wales: Waiting times hit record levels

The numbers on waiting lists for non-urgent hospital treatment in Wales have again hit record levels.

There were 624,909 people waiting in June, with the list climbing steadily each month and up by 41% since the early days of the Covid pandemic.

Those waiting the longest, more than nine months, rose again to 233,210.

A&E waiting time performance was the worst on record and Conservatives called the figures “catastrophic”.

Emergency departments and the Welsh ambulance service both had their busiest months since the pandemic began.

A&E waiting times were the worst for a second month in a row – with only 69.8% of patients spending less than four hours waiting to be dealt with.

The headline figure for the number of patients waiting for non-urgent hospital treatment has been growing since the pandemic began, not helped by surgery being postponed during the first Covid wave.

There were another 17,869 people added to the list in the past month and numbers waiting more than nine months grew by 5,457.

A Welsh government spokesperson said: “Waiting times for treatment continue to grow.

“However, it is encouraging to see progress being made with the number of patients waiting over 52 weeks falling for the third month in a row.

“We also saw the largest number of specialist consultations completed and treatments started in any month since the start of the pandemic.”

It comes as Wales’ health minister pledged £551m to help health and social services recover from the pandemic.

Eluned Morgan said Covid had had a “massive impact” on the NHS and social services in Wales and was still facing significant costs in dealing with it.

The figures for June 2021 show:

• The overall waiting list for treatment is a record 624,909
• Numbers of patients waiting more than 36 weeks – nine months – to start treatment in hospital have grown from 25,634 in February 2020 to 233,210 (an increase of 810%)
• The longest waits included 54,394 people due for orthopaedic or trauma treatment – a 546% increase since February 2020
• Inroads have been made into those waiting for cardiothoracic surgery, but there were still 108 waiting more than nine months, more than twice the pre-pandemic number
• Another 34,104 people have been waiting more than nine months for ophthalmology treatment – compared to 4,083 before the start of the pandemic
• Numbers waiting for diagnostic tests were “markedly higher” than before the pandemic
• Cancer patients who started their first definitive treatment within 62 days of it first being suspected was the second highest number on record although performance against the 62 day target fell slightly on the previous month.

The figures also show the Welsh Ambulance Trust received more calls in July than in any month since the pandemic began – with the highest proportion of “red” calls, those immediately life-threatening emergencies, on record.

There were also the highest attendances at A&E departments since the pandemic began and waiting time performance was the worst on record.

The target is that 95% of patients should be seen within four hours but that fell to 69.8% in July.

This dropped as low as 44.7% at Glan Clwyd Hospital in Denbighshire and 43.8% at the new Grange University Hospital in Torfaen.

The Grange, which opened in the middle of the pandemic last November, had nearly 8,000 people through the doors of its emergency department in July.

The monthly performance was the second-lowest ever for a Welsh A&E unit, after Wrexham Maelor Hospital in February last year.

Overall in Wales more than 7,000 patients waited more than 12 hours in A&E – one in 10 patients and another record high – with the target that no-one should wait that long.

Senior consultants said there was a “severely challenging situation,” with “unrelenting pressure” on staff and fears the NHS would not be able to cope, with added winter pressures looming.

“Staff are already facing burnout, exhaustion, stress and moral injury,” said Dr Suresh Pillai, vice president of the Royal College of Emergency Medicine Wales.

“The health service and its workforce need the assurance that there is a robust and comprehensive plan to manage this likely increase in demand and provide adequate resources for staff and departments.”

‘Catastrophic’

There were 94,176 attendances to emergency units over the month.

For the ambulance service, only 57.8% of more than 3,580 red calls arrived within eight minutes compared with the target of 65%. This was down from 60.6% in the previous month.

But more people started treatment for cancer in the latest month than in the previous month.

The total number of patients starting their first cancer treatment and the number of patients starting their treatment within the target time were the second highest since the current records began.

The Conservatives called the figures “catastrophic”, saying Wales should be seeing improvements after it moved from the peak of the pandemic.

Health spokesman Russell George said: “To record the worst ever A&E waiting times and the longest NHS treatment waiting list in the same month shows a complete lack of leadership.”

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No plane leaving empty, said the UK defence secretary

No plane carrying Britons and Afghans from Kabul has left empty, the UK defence secretary has said.

Ben Wallace rejected reports that some flights from Kabul contained only a few people, saying the UK was “absolutely ploughing through the numbers”.

He told BBC Breakfast “every hour counts” and confirmed “the Taliban are letting our people through”.

But Taliban checkpoints ring the perimeter of the airport and chaotic scenes are unfolding outside.

About 4,500 US troops are in temporary control of Karzai International Airport, with about 900 British soldiers also on patrol at the site as part of efforts to secure the evacuation flights.

The Taliban are blocking Afghans without travel documents from entering. Twelve people have been killed in and around Kabul airport since Sunday, according to a Taliban official quoted by the Reuters news agency.

But even those with valid papers have struggled to get to the airport, with reports that some have been beaten by Taliban guards.

An Afghan interpreter who worked for the British army said he received permission to come to the UK last week, but was now in hiding and would “face death” if the Taliban found him.

Peymana Assad, a London councillor who was visiting relatives in Kabul, said she joined hundreds of people walking along the traffic-jammed road to the airport to escape – only to find she reached the UK meeting point too late.

Ms Assad, who had previously left Afghanistan as a three-year-old refugee, said a local family allowed her to wait at their home until she could contact the Foreign Office and arrange to join a later RAF evacuation flight.

The defence secretary said the UK would continue to stay in Afghanistan as long as the US ran the airport, but said the government was also already investing in “third country hubs” for processing people “if they get out to other countries in the region”.

Mr Wallace said seven to 10 RAF planes were taking off every day, with at least 138 due on the next flight out.

He said the passengers on the flights out of Afghanistan this week had included British government personnel, British citizens, media and human rights staff and Afghans who had worked for the UK.

Downing Street said military flights took about 1,200 people out of Kabul between Saturday and 08:00 BST on Wednesday, about 900 of whom were Afghan nationals and the remainder British citizens.

Since late June, 2,000 Afghans who worked for the UK have been resettled with their families under the Afghan Relocations and Assistance Policy (ARAP), according to the Home Office, with a target of 5,000 by the end of 2021.

The UK has also committed to take in up to 20,000 Afghan refugees over the next few years under a separate resettlement scheme – including 5,000 this year.

Two evacuation flights came into the UK on Wednesday, the Minister of Defence said – a military plane into RAF Brize Norton in Oxfordshire and a passenger plane into an unnamed civilian airport.

On board were Afghans being relocated under the ARAP scheme for those who worked with the British military, British citizens and some other foreign nationals. The MoD did not provide exact numbers but said each flight could hold about 250 passengers.

Eight RAF transport aircraft – a mix of A400 Atlas planes, C-130 Hercules aircraft and C-17 Globemasters – were due to fly to Kabul on Thursday.

Foreign Secretary Dominic Raab said on Twitter that another 10 Foreign Office and Home Office staff had been sent to Afghanistan to help with the evacuation.

US President Joe Biden said US troops may stay in Afghanistan beyond his withdrawal deadline at the end of this month.

He told ABC News between 10,000 and 15,000 Americans needed to be evacuated, along with 50,000 to 65,000 Afghans such as former translators for the American military.

Mr Wallace said a plane left Kabul on Thursday morning carrying “115 people and their families – those are the Afghans on there as opposed to other personnel”.

He added: “None of our planes are leaving empty… our planes never leave empty. If we have spaces on them, we offer them up to other nations.”

Downing Street said the UK helped to fly 76 Australians out of Afghanistan on an RAF plane on Wednesday.

image caption British nationals and Afghan evacuees depart a flight from Afghanistan at RAF Brize Norton on 17 August 2021

He said: “We have a full programme today of many more people coming out – trying to reach our… capability towards the end of the month. And that is so far on track…. we are doing it as fast as we can.”

Mr Wallace said many of the flights were at full capacity.

“You and I wouldn’t be allowed to fly some of the way those planes are flying in safety, so we are taking considerable risk”, he said, adding: “Alongside those people will be troops or others coming in and out.”

The defence secretary said additional UK troops would be deployed to Afghanistan to help manage public order on the ground at Kabul airport.

Meanwhile, Labour has accused Foreign Secretary Dominic Raab of putting interpreters’ lives at risk after he declined to phone the Afghan foreign minister to get help for the evacuation. The BBC has been told the call was made by a junior minister instead.

But Mr Wallace said “the only thing that mattered” was whether Kabul airport would continue to allow people to get out, telling Breakfast: “No amount of phone calls to an Afghan government at that time would have made any difference.”

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Covid-19: Health service in NI ‘faces a very difficult winter’

Northern Ireland is facing “a very difficult winter” due to rising Covid-19 cases and a return of other respiratory viruses, the chief medical officer has warned.

Sir Michael McBride said people had not been exposed to many viruses other than Covid-19, contributing to a “perfect storm” of additional pressures.

He said hospitals were already under pressures normally seen in mid-winter.

Hospital staff were “physically tired and exhausted”, he added.

On Thursday, nine more coronavirus-related deaths were reported in Northern Ireland, and another 1,963 new cases.

Chief scientific adviser Prof Ian Young said the number of people dying with Covid-19 may not hit a peak “for a couple of weeks”.

Sir Michael told Stormont health committee on Thursday that Northern Ireland faced a “challenging flu season”.

“It feels like the middle of the winter at this present moment in time. If you’re in discussion with our frontline staff, you will know that,” he said.

Sir Michael said patients were presenting with complications as a result of being unable to access care when they needed it because of “excessive wait lists”.

“I can only but apologise for the excessive waits. Now people are presenting with complications as a result of the excessive waits that they’ve had to access treatment.

“If you then imagine potentially 400 to 600 Covid admissions on top of that by late summer into September time, then you can imagine the perfect storm of additional pressures.”

Convenience key to youth vaccine

About 180 people had received their first dose of the Covid-19 vaccine at a walk-in clinic at Queen’s University on Wednesday, Health Minister Robin Swann told the committee.

Asked about vaccine hesitancy among young people, Mr Swann said staff on site had engaged with walk-ins to see why they had not previously booked.

“What they were getting is ‘well sure this is handier’,” the minister said.

“So it is about our younger age group, if they have to book maybe not as many are engaged as we’d like to be, but if it’s on their doorstep, if they can walk past and walk in they are doing that.”

His comments come as the first and deputy first ministers urged young people to get vaccinated at the upcoming “big jab weekend“.

Mass vaccination centres will be offering walk-in first jabs for all adult age groups on 21 and 22 August.

‘Take the knees out from under us’

Earlier, Dr David Farren, a microbiologist and infection control doctor with the Northern Health Trust, said hospitals were as busy now as they were in January this year, and the pressure “has not stopped”.

He said the profile of patients had “completely changed” from the elderly and medically vulnerable, to unvaccinated young people.

Speaking to BBC NI’s Good Morning Ulster programme, he said: “It’s no longer the elderly, infirm, clinically extremely vulnerable people that we’re seeing in. We’re seeing unvaccinated young people who don’t have any other illnesses.

“Every single day that we see this we’re wondering how much further can we go, how much more can we give, all the while we know that on the horizon we have the flu season coming up, we have the winter vomiting bug coming up, we have bronchiolitis in kids coming up and if all those hit, it will be a perfect storm that will just take the knees out from under us.”

Currently, about 86.3% of adults in Northern Ireland have had at least one dose of the vaccine.

Just over 77% are fully vaccinated. That compares to about 89.6% in the whole of the UK.

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