Huge regional inequalities in waiting lists as new data analysis reveals the lasting impact of the pandemic

• LCP launches a new accessible and interactive tracker to explore how waiting lists vary across England
• The total number on waiting lists has increased by 21% to 5.1 million, an additional 886,000 since the pandemic began, but this has been felt unequally across the country
• The number of people waiting more than 52 weeks has declined by 12% from 436,000 to 385,000 from March 2021 to April 2021
• Orthopaedic waiting lists have experienced the largest increase in waiting list size, with over 146,000 more than when the pandemic began
• Nearly 70 times more people are waiting over 52 weeks for orthopaedics in Norfolk & Waveney and Devon compared to North East Lincolnshire and Blackburn with Darwen
• Nearly one in four people on an orthopaedic waiting list in Norfolk and Waveney, North Cumbria and Blackpool are waiting more than a year compared to 1 in 40 in Ealing
• The Gynaecology waiting list has increased by 38% since the pandemic began, the largest relative increase across all specialties

Analysis from a newly launched NHS waiting list tracker from LCP’s Health Analytics team has revealed the stark and widening inequalities in waiting times across clinical commission groups (CCG) as the indirect impacts of the Covid-19 pandemic become clear across the NHS.

The direct impacts, infections and deaths, of Covid-19 were felt unequally and the resulting pressures on routine NHS services threatens to worsen existing health inequalities. There are around double the number of people on waiting lists per 100,000 in Castle Point than in Central London, and while 9,221 people are on a waiting list in West Lancashire CCG, the number is around 20 times higher in North East London and Birmingham and Solihull CCG at 180,095 and 164,547 respectively.

Commenting, Dr Jonathan Pearson-Stuttard, head of LCP’s Health Analytics team, said: “England’s growing waiting lists are a worrying indirect impact of the Covid-19 pandemic. The LCP waiting list tracker provides timely and place-based data presented in an accessible and digestible format. This transparency of health-need is crucial to inform efforts to level-up health and deliver on the Government’s manifesto pledge”

An increase in patients waiting more than 52 weeks for Orthopaedics

Orthopaedics has experienced the largest increase in waiting list size, with 146,000 added since March 2020. This new analysis identifies worsening regional disparities. There are nearly 70 times more people waiting more than 52 weeks for orthopaedics in CCGs such as Norfolk and Waveney, and Devon compared to North East Lincolnshire, Blackburn with Darwen (see tables below).

When adjusting for CCG population size this gap reduces but still persists at approximately 30-fold difference between CCGs with the highest and lowest number of patients waiting more than 52 weeks. The best performers are south west London, Surrey Heartlands and North East Lincolnshire CCGs with the lowest waiting list times, compared to Castle Point, Southend, Norfolk and Blackpool which have the highest waiting list numbers per 100,000. This is starkly highlighted by the finding that nearly one in four on the orthopaedics waiting list in Norfolk and Waveney, North Cumbria and Blackpool are waiting more than 52 weeks, with this number around one in forty in west London.

Dr Jonathan Pearson-Stuttard commented: “The number of patients waiting over 52 weeks for Orthopaedic services across England is extremely worrying. We know that for many of these conditions, longer waiting times is associated with poorer long-term outcomes. Without urgent action targeting areas with the highest unmet need, we risk a generation of patients living in poorer health.”

Increase in waiting times varies across specialty

LCP found that 14 out of 19 specialties have experienced an increase in waiting list size, but the difference between specialties is stark. Gynaecology has experienced the largest percentage change, at 38%, while Dermatology waiting lists increased by just 2%.

Rajiv Gogna, Partner, LCP Analytics commented:

“Alongside the inequalities in waiting lists by geography, the increase has been felt unequally across specialties. Gynaecology and general surgery are two of the hardest hit specialties and additional resources should be targeted at specialties and patients most adversely affected over the past year.”

Data and statistics

Table 1: Number of patients waiting more than 52 weeks for Orthopaedics (Absolute numbers)

Table 2: Number of patients waiting more than 52 weeks for Orthopaedics (Numbers per 100,000)

Table 3: Number of patients waiting more than 52 weeks for Orthopaedics (% of waiting list)