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NHS will face a ‘winter of woe’, surgeons warn

The NHS will face a ‘winter of woe’ unless patients are discharged quicker to free up beds for more operations, leading surgeons have warned.

The Royal College of Surgeons (RCS) stressed hospitals and local authorities need to work together to improve handover of patients.

A total of 181,692 ‘bed days’ were lost to delayed discharges in July 2017. This is when patients are fine to go home, but can’t be discharged safely. 

Nearly four million patients are currently waiting for surgery, startling new figures show, as waiting lists continue to grow across the country. 

NHS England data showed 3.85 million patients on the waiting list for non-urgent hospital care in July – a slight increase on the record-breaking June.

Of these, some 420,000 patients have had to wait longer than the 18-week mark – a time target introduced by the last Labour government in 2007. 

The Royal College of Surgeons stressed hospitals and local authorities need to work together to improve handover of patients

Professor Derek Alderson, president of the RCS, said: ‘There’s a distinct chill in the air that tells us winter is creeping ever closer.

‘Today’s performance data worryingly suggests that the NHS is not ready for the pressures this will bring.’

Too many operations cancelled 

He added: ‘Last winter we saw patients waiting unacceptably long for both emergency and planned care, with far too many operations cancelled. 

‘Skilled surgeons and operating theatre staff were also left kicking their heels because there were not enough beds available for patients to go to after surgery, wasting valuable resource.

‘NHS staff are doing the best they can with the resource they’ve been given and the unabating pressure they’ve tackled this year means morale remains low. 

‘Unless patients are moved more quickly to community care and planned bed capacity is better protected, the NHS will face a winter of woe, with patients feeling the brunt of this.’ 

Vital to free up beds 

Simon Stevens, chief executive of NHS England, told a conference earlier this week speeding up discharges would be ‘vital’ to cope with the rising demands.

The ‘bed blocking’ crisis has previously been blamed for its knock-on impact on the entire health service, with so many beds taken up that operations have to be cancelled and patients have to wait longer to be admitted.


The number of patients enduring long waits for hip and knee surgery and similar operations will double over the next two years, NHS bosses admitted in May.

They predict that up to 800,000 patients will be made to wait 18 weeks or longer for routine surgery by 2019.

Projections also show that there will be almost 5.5 million patients on hospitals’ waiting list, up from the current 4 million.

Just six weeks ago the head of the NHS Simon Stevens warned patients to expect longer waits for routine surgery.

Mr Stevens said the delays would be a pay-off for the health service prioritising other areas of care including cancer, GP surgeries and mental health.

The latest figures are contained in a document from the watchdog NHS Improvement by the Health Service Journal. 

A lack of social care places is at a record high with more than 2,500 health patients prevented from leaving hospitals each day, it was reported last year – specifically because there is nowhere for them to go.

Time targets 

The 18-week time target was designed to stop many having to endure long waits for common procedures, but in recent times has been subject of a clampdown.

In March, NHS bosses relaxed time targets for patients set to have cataract removal, hernia repair and other non-urgent operations.

But experts immediately hit back and slammed officials for ‘waving the white flag on the 18-week target’ by asking for just 92 per cent of patients to have treatment.

At the time they warned it could see the number of people waiting for surgery within 18 weeks breach the four million mark for the first time in 10 years.

Such targets have only been broken once since the inception of the time target, in August 2007 when 4.18 million were waiting.

The month after dipped just under the mark, with 3.99 million being placed on the referral to treatment scheme.

Waiting times have continued to soar since January this year, with slight increases recorded in each month following on. 

The warning comes just a day after hospitals and GP surgeries were told to brace themselves for a severe flu outbreak this winter.