PRESS RELEASE: Cancellations of NHS care are having serious impacts for patients 27.7.23
New research published by Healthwatch England highlights:
- Impact of NHS pressures revealed in a new survey of 1084 people whose care has been cancelled this year.
- Over one in three, 39%, have experienced cancellations or postponements of care two or more times.
- Disruptions to care disproportionately affect unpaid carers, neurodivergent people, and those on lower incomes, widening existing health inequalities.
- Healthwatch England has urged healthcare leaders to act on the number of cancellations, especially those that occur at the last minute, and ensure more significant support for those most affected.
- Across Sussex, strikes are estimated to have required 19,000 patients to have their appointments rescheduled.
New research, published today (27.7.23) by Healthwatch England, shows that people are currently facing multiple cancellations or postponements of care which are having a significant impact on their lives and symptoms, while further increasing health inequalities.
About the research
Healthwatch England commissioned a survey of 1084 people who have seen their NHS care either cancelled or postponed this year to understand the extent of disruption to care amid rising waiting lists, workforce issues, and industrial action, and other pressures on the NHS.
Key findings
- Over one in three, 39%, have had their NHS care cancelled or postponed two or more times this year. This has included hospital operations, tests, scans, outpatient appointments, and community health service appointments.
- Nearly one in five (18%) of the respondents have had their care cancelled or postponed at the last minute, which the NHS defines as on the day of or on arrival to an appointment. And almost half, 45%, experienced a cancellation with between one- and seven-days’ notice.
- Two-thirds of the respondents, 66%, said cancellations to care had impacted their lives, reporting ongoing pain, worsening mental health, worsening symptoms, and disrupted sleep, among many other problems.
NHS pressures widen existing health inequalities
Disruptions to care disproportionately affect certain groups, widening existing health inequalities. People who have greater health needs are still facing serious barriers to timely care, and they are also more likely to be more affected by cancellations of care.
- Unpaid carers, 84%, and neurodivergent people, 83%, were more likely to report negative impacts of cancelled care on their lives, followed by people on low incomes, 80%; and those from minority ethnic backgrounds, 75%.
- Groups who were more likely to have had two or more NHS postponements or cancellations included disabled people, 52%; neurodivergent people, 51%; and people on lower incomes, ethnic minorities and LGBTQ+ being affected the most, 49%, respectively.
Across Brighton and Hove, we have also heard stories about the impacts of cancellations and delays on patients:
- A patient who has been waiting for surgery for 11 months. While waiting, further scans have revealed a cyst has doubled in size and another has developed. The patient has been put on the waiting list for surgery but without any indication of how long the delay will be.
- A patient waiting for a cataract operation since June 2022 which told us the delay:
“… has ruined my vision, I cannot read books, PC screens or concentrate for long periods on any visual activity. I feel angry and feel left visually disabled. Many people tell me I should go private but paying £2,000 for an operation is beyond my means.”
- A patient waiting for a cancer operation, which has been cancelled twice.
- A patient who turned up for an appointment at Louise Martindale Hospital only to find out it had been cancelled. A letter cancelling the appointment had not arrived and no call or text sent either. The patient had taken the day off work to attend, which was wasted.
- A patient trying to sort out an outpatient appointment at the Digestive Diseases unit at RSCH was unable to speak to anyone and emails went unanswered.
The Healthwatch England survey also found:
- More than three-quarters, 79%, of the respondents said the NHS had offered them ‘very little’ or ‘no support’ to manage their mental health risks.
- More than half, 52%, said they hadn’t been offered support to manage their medical condition during the new wait for care, 24% had had ‘a lot’ or ‘some’ support and 21% said ‘a little’ support.
- One in seven,15%, were told their care had been cancelled due to industrial action in the NHS, while nearly a quarter, 24%, believed strike action was the reason, though they had not been told this.
- Nearly half, 41%, said their care was cancelled for another reason; and 20% didn’t know why.
Initial analysis of people with a date for a hospital appointment or a test, showed one in four had had this care postponed or cancelled in 2023.
At the time Healthwatch England launched the research, the NHS had already rescheduled more than 648,000 operations or appointments since mid-December 2022, due to industrial action taken by staff in their pay dispute with government.
“The findings show that many people are currently facing worsening and, in some cases, catastrophic health impacts due to ongoing delays to care. And addressing health inequalities continues to be a significant challenge for the NHS. People who often face serious difficulties accessing specialist NHS care, such as unpaid carers, neurodivergent people, and those on lower incomes, are also those who are suffering the most from ongoing cancellations. If their symptoms worsen or their mental health deteriorates, this in turn puts extra pressure on health and care services. While we welcomed the recently announced long-term NHS workforce plan, we need to see action to tackle the cycle of high patient need and ongoing pressures in healthcare now. We urgently need to reduce the number of cancellations of appointments, especially last-minute cancellations, and greater action is needed to address widening health inequalities. With industrial action in the NHS being one of the many factors impacting on people's ability to access timely care, we are also renewing our call for all parties to reach a resolution to mitigate the impact of strikes on patients.”
“Delays and cancellations ultimately impact most on patients, their families and carers. Waiting times were severely impacted by COVID-19 and were only just showing signs of recovery. But over the past months there have been increases in people waiting 65 weeks and more than 104 days for cancer appointments. Delays also affect some people trying to see their GP or a dentist for NHS treatment. A public priority for our health care system is to increase access to primary care services and reduce diagnostic and planned care waiting lists. This is detailed in ‘Improving Lives Together: Our Plan for our Population’ which was published in July. This recognises:"“There are currently large numbers of people waiting too long for diagnostic services and planned care, which can cause a deterioration in their condition, impact on their day-to-day lifestyle ad affect their general health and wellbeing.” Those in charge of our health care system have set clear and challenging targets to reduce waiting times and reduce missed appointments. Our hospitals are also continually prioritising patients based on clinical urgency. Plans to improve communication should mean that patients will be kept better informed via the NHS APP of their appointment and also enable them to change or cancel their appointment. We know that once people receive their treatment or care, their experience is generally positive and the efforts of staff are recognised but more can be done to reassure patients whilst they wait including better communication and signposting to services so that they can take better care of themselves.”
“We know how difficult it is for patients and their loved ones when their care is rescheduled. We never take such decisions lightly but given current demands and ongoing strikes, sometimes we need to change plans to prioritise safety and maintain life-preserving care for others. We are very sorry for the impact this has on patients, both physically and mentally, and wish to thank Healthwatch for their national research that raises some serious issues concerning effects on health and wellbeing, equality of impact and communications. We will continue to work closely with Healthwatch Brighton and Hove locally to help us improve our communication with patients and ensure everyone is treated as fairly, and as swiftly as possible.”
Background to the Healthwatch England survey
Healthwatch England commissioned Yonder Data Solutions to run an online survey.
Fieldwork was carried out between 26 June and 3 July 2023 in two phases:
1. An initial survey of 1,038 nationally representative people to understand: how many were NHS users and of those, how many had had cancelled care in 2023. Out of 1,038, 55% (568) confirmed they were an ‘NHS user’, which meant they either had an appointment for, had recently had an appointment for, or were on a waiting list for a diagnostic test/scan, operation/procedure, hospital outpatient appointment, or community hospital/service appointment. Of this group of 568 people, 141 people (25%, or 1 in 4) said they their care had been cancelled.
2. In order to look beyond the topline statistics in the initial sample, Yonder Data Solutions continued with fieldwork to boost the number of respondents to reach a total sample of 1,084 people whose care had been cancelled or postponed in 2023. Where different demographic groups have been compared e.g., carer versus non-carer, only those where significant differences (at 5% risk level) have been found, are displayed.
