NHS waiting lists reach record levels, but what about the ‘hidden waiting list’?

13 April 2023

The latest NHS data shows that a record number of people are waiting for care. However, new research from Healthwatch indicates that there is also a hidden waiting list, and more needs to be done to understand what it’s like for people trying to get referred.

New NHS data indicates that over seven million people are on waiting lists for specialist clinical care or surgery.

• The waiting list grew to a record 7.22 million in February
• Progress was made seeing people waiting the longest
• But 362,498 appointments require waits of over one year
• And 92% of appointments require waits of up to 46.2 weeks

However, according to new research, the NHS has a ‘referrals blind spot’ as times for getting a GP referral vary considerably.

Healthwatch’s report, which looked at the experience of 1,500 people trying to get a referral to a hospital from their GP, found that it can take time to get on an NHS waiting list with:

• Nearly one in five people (18%) having to attend four or more GP appointments before getting a referral; and
• 11% of people waited over four months from their first GP appointment to being referred.

People who didn’t get a referral also reported that their symptoms worsened, impacting their mental and physical health and ability to work.

Most respondents (82%) also said they had tried alternative routes for help after failing to get a referral. These routes included moving GPs, contacting a hospital directly or attending A&E.

Responding to the latest NHS data, Healthwatch Chief Executive Louise Ansari said: 

“Record levels of people waiting for hospital care frustrates patients and puts enormous pressure on NHS staff. But, if you consider those still waiting to be referred, people feel the impact of current challenges long before joining a waiting list.

“People have told us how difficult it can be to get a hospital referral in the first place. Some wait months due to repeat appointments with GPs before a referral, missing records, and delays once a GP has agreed to make a referral. This hidden waiting list remains largely unknown to the health system.

“The result is a large number of people repeatedly returning to their GP, or seeking support from A&E. Combined with the sheer numbers waiting for an operation, consultation, or treatment, this places additional pressure on every part of the NHS, greatly impacts people’s lives, and can put patients at risk.

“Although the NHS is making progress in bring down waiting times, there will be no quick fix and industrial action is making the situation worse. However, it remains vital that people are supported to manage pain and their mental health whilst they wait. And the NHS can do more to understand and improve the referral process, investing in the systems and administrative staff they need to support and communicate with patients while they wait.”