Even as the NHS faces an 'exceptionally tough challenge', millions of people are still getting care for non-Covid health problems according to NHS England.

It says that new data shows that cancer treatment and referrals are back to usual levels, with more than 25,000 starting treatment in November and more than 200,000 people referred for checks. 

Nuffield Trust analysis of the data found that 205,182 patients had a first consultant appointment for suspected cancer in November 2020 following an urgent GP referral – 2% higher than in November 2019. This follows a substantial drop to less than 80,000 first consultant appointments in April 2020.

In November 2020, almost one in four patients (24%) waited longer than two months to start their first treatment following an urgent GP referral for suspected cancer. 

The percentage of patients who waited longer than two months to start their first treatment for cancer following a referral from a national screening service decreased to 12% in November 2020, following the recent worsening to 87% in June 2020. 

Urgent and elective care 

In addition, half a million more people sought help in England’s A&Es in December compared with the first peak of the pandemic in April.

Nuffield Trust analysis shows that in December 2020, total A&E attendances fell to just under 1.5 million – 32% lower than in December 2019. This follows a decrease to 916,581 in April 2020 and a subsequent increase to just over 1.7 million in August 2020. Around 1 million attendances in December were to major (type 1) A&E departments.

In November 2020, there were over 1.6 million first outpatient attendances for general and acute specialties – more than double the low of 783,259 in April 2020 but 18% lower than in November 2019. The number of elective admissions decreased to 588,345 – 21% lower than in November 2019.

The total number of people waiting to start consultant-led elective treatment increased to over 4.5 million in November 2020 (reported waiting list plus the estimate of missing data). This follows a previous fall to 3.9 million in May 2020.

NHS has cared for nearly a quarter of a million Covid-positive patients 

Professor Stephen Powis, NHS national medical director, said: “Despite 2020 being the year of Covid, nearly 20 million people received emergency care in England’s A&Es, while in November alone as Covid-19 was spreading more rapidly, patients still benefitted from four million important elective treatments and essential checks on the NHS.

“And actually, hardworking staff have ensured that the waiting list is lower than it was at the same point last year with the average waiting time for treatment, improving comparing to the previous month. The NHS has cared for nearly a quarter of a million Covid-positive patients already, who collectively spent more than two million nights in hospital, while also keeping emergency care running."

He added that for every Covid patient in hospital, the NHS is treating three people for other conditions so there is no doubt that services will continue to be under additional pressure until and unless this virus is under control.

Staff are going the extra mile putting themselves under mental and physical strain

Siva Anandaciva, Chief Analyst at The King’s Fund, said that the figures overall show that the NHS is now under the most extreme pressure seen in recent history and is battling on multiple fronts. Staff are exhausted, wards are overflowing and patients face long waits for routine and emergency care, with many procedures being cancelled or postponed.

She added: "Despite staff doing their best under incredibly difficult circumstances, waits for routine care have rapidly ballooned, with 192,000 people waiting over a year for care compared to just 1,400 this time last year. But this is only part of the problem. Last week, more than 3,700 patients had to wait 12 hours or more in A&E before being admitted to hospital – the highest number since current records began, and even urgent operations are being cancelled in some parts of the country.

"GPs are seeing high numbers of patients at a time when they are also working flat out to deliver a monumental vaccination programme. Staff are going the extra mile, putting themselves under mental and physical strain. Vaccines will provide some relief but one of the lessons that must be learned is that the goodwill and hard work of frontline staff is not enough to overcome long-standing staff shortages and reduce waiting times which were rising well before the pandemic struck."