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NHS faces ticking ‘time bomb’ of 8m cancelled or delayed operations due to anaesthetist shortage

The NHS is facing a “time bomb” and will be forced to cancel or delay around 8 million operations each year by 2040, due to a lack of consultant anaesthetists across the services.

The Royal College of Anaesthetists (RCOA) said the current shortage of at least 1,400 staff across the UK means millions operations will not be able to take place.

The college has warned its speciality is facing a “perfect storm” of limited training places, poor retention and an ageing workforce with 39 per cent nearing retirement age.

The analysis found as demand for surgeries continue the need for anaesthetists is due to increase by 3.85 per year, meaning the NHS will need around 25,000 doctors in these posts by 2040.

Dr Fiona Donald, president of the RCOA said: “The NHS is facing an anaesthetic workforce time bomb. We already have profound workforce shortages that are preventing huge numbers of operations from taking place – and unless urgent action is taken, the problem is going to worsen.

“We would welcome government funding for additional anaesthetic training posts. One hundred additional posts per year would start to plug the gap and help get the UK back on a sound footing to be able to address the waiting list backlog. Without this investment, we foresee impacts to patient care and a further impact on the mental health of our current workforce – they need to be able to prioritise their own health and that of their families alongside the focus they already place on the health of patients and the public.”

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Source: The Independent, 22 February 2022

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NHS faces legal action from ‘abandoned’ IV feed patients

The NHS and the national medical regulator could face legal action over the shortage of intravenous feed supplies for hundreds of UK patients, HSJ has learned. 

The law firm acting for more than a dozen patients affected by the shortage of feed supplies has confirmed to HSJ it has been instructed to take action against NHS England, the Department of Health and Social Care, the Medicines and Healthcare products Regulatory Agency and the company responsible for producing the feed, Calea. 

Since June, hundreds of patients who rely on IV feed known as total parenteral nutrition have gone without deliveries of their bespoke feed. More than 40 people have been admitted to hospital as a result.

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Source: HSJ, 29 August 2019

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NHS faces huge clinical negligence legal fees bill

The NHS in England faces paying out £4.3 billion in legal fees to settle outstanding claims of clinical negligence, the BBC has learned through a Freedom of Information request. Each year the NHS receives more than 10,000 new claims for compensation. 

The Department of Health has pledged to tackle "the unsustainable rise in the cost of clinical negligence".

Estimates published last year put the total cost of outstanding compensation claims at £83 billion. NHS England's total budget in 2018-19 was £129 billion.

The Association of Personal Injuries Lawyers (APIL) believes the cost is driven by failures in patient safety.

Doctors represented by the Medical Defence Union (MDU), which supports doctors at risk of litigation, are calling for "a fundamental" reform of the current system.

Suzanne White, from APIL, said people came to her on a daily basis with no intention of suing the NHS. But she said they often found it difficult to get answers from the medical authorities - and were left with no other option but to sue.

"What they want to do is find out what went wrong, why they have received these injuries ... and to make sure it doesn't happen to other patients."

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Source: BBC News, 21 January 2020

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NHS faces exodus of doctors after Covid pandemic, survey finds

Thousands of UK doctors are planning to quit the NHS after the Covid pandemic because they are exhausted by their workloads and worried about their mental health, a survey has revealed.

Almost one in three may retire early while a quarter are considering taking a career break and a fifth are weighing up quitting the health service to do something else.

Long hours, high demand for care, the impact of the pandemic and unpleasant working environments are taking their toll on medics, the British Medical Association findings show.

Dr Chaand Nagpaul, the leader of the BMA, said the high numbers of disillusioned doctors could worsen the NHS’s staffing problems and leave patients waiting longer for treatment.

“It’s deeply worrying that more and more doctors are considering leaving the NHS because of the pressures of the pandemic – talented, experienced professionals who the NHS needs more than ever to pull this country out of a once-in-a-generation health crisis,” Nagpaul said.

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Source: The Guardian, 2 May 2021

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NHS faces beds crisis as care homes stop taking patients from hospitals

The NHS faces a mounting beds crisis as care homes suffering unprecedented staff shortages are forced to stop taking patients from hospitals, health and care leaders have warned.

Ministers are desperately trying to free up space in the NHS to tackle a backlog of 5.6 million people – equivalent to almost 10% of people in England – awaiting treatment.

But efforts to speed up the discharge of hospital patients into the community are being hampered by care worker shortages. Britain’s largest not-for-profit care home provider, MHA, has already had to close 1 in 10 of its homes to admissions from hospitals, its chief executive, Sam Monaghan, told the Guardian.

The warning comes as a comprehensive assessment on Wednesday reveals that care homes in England are facing the biggest staff shortage on record, with 105,000 positions unfilled according to the 2021 State of the Adult Social Care Sector and Workforce report by Skills for Care, an industry body.

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Source: The Guardian, 13 October 2021

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NHS faces an Easter 'as bad as any winter'

NHS leaders are warning that the health service is facing the "brutal reality" of an Easter as bad as most winters.

Latest data shows record waits for planned surgery and in A&E, as staff plough through a backlog fuelled by Covid. The government says there is hope on the horizon.

Jean Shepherd, 87, had a stroke in April last year, leaving her severely disabled and requiring round-the-clock care.

At the end of February there was an outbreak of sickness at her nursing home and she needed hospital treatment. She had to wait in a wheelchair for more than 9 hours until an ambulance arrived to take her to A&E. She then spent 31 hours on a trolley between the emergency department and a secondary-care unit.

"She was very distressed because she doesn't like hospitals at the best of time," says her son, Andy Shepherd. "Since the stroke, because of her cognitive ability, she doesn't understand what's happening around her."

Mrs Shepherd was eventually moved to a bed in a main hospital ward, where her family says she later contracted Covid, before recovering and being discharged back to her care home two weeks later.

"I appreciate that A&E departments have always been busy, but I just wasn't prepared for what greeted me at the hospital," says her son.

"There were patients on ambulance trolleys literally everywhere and the staff were absolutely rushed off their feet. I remember thinking at the time that this is not sustainable."

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Source: BBC News, 14 April 2022

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NHS faces £90bn bill for ‘staggering’ maternity blunders

The NHS faces a record £90 billion maternity bill, The Telegraph can reveal ahead of a “harrowing” report into failings at East Kent Hospitals Trust.

Official figures show the number of claims have risen by almost one quarter in just two years following a series of scandals. 

The data show 1,243 maternity negligence claims in 2021/22 - up from 1,015 in 2019/20. 

Safety campaigners said the figures were “staggering” - with £90 billion now set aside to cover the costs of claims.

It means that in total, 70% of total liability provision for NHS negligence is associated with failings in pregnancy and childbirth, amid rising claims. 

The figure - equivalent to two-thirds of the NHS annual budget - represents an estimate for the total costs if all claims it expects to settle were paid out, at today’s prices.

An NHS spokesperson said: “Despite improvements to maternity services over the last decade – with significantly fewer stillbirths and neonatal deaths – we know that further action is needed to ensure safe care for all women, babies and their families.

“The NHS is ensuring that work is already underway to make these improvements, including a £127 million investment this year to boost the maternity workforce, strengthen leadership and increase neonatal cot capacity – which is on top of an annual boost of £95 million for staff recruitment and training announced last year.”

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Source: The Telegraph, 18 October 2022

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NHS faces £5.7bn bill for patching up hospitals before demolishing them

The repairs bill at 18 crumbling hospitals is set to soar to £5.7bn because replacing them will take so long, new analysis shows. 

Reconstruction of 18 of the 40 new hospitals in England first promised by Boris Johnson in 2019 will not start until at least 2030 – the date by which all 40 were originally meant to open – to help spread the cost, amid stretched public finances.

NHS trust bosses have warned that some of the 18 hospitals hit by the delays, such as St Mary’s in London, will collapse before work starts because they are already in such an advanced state of disrepair.

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Source: Guardian, 16 February 2025

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NHS faces ‘tipping point’ in England where most appointments will not be with GPs

The NHS in England is heading towards a “tipping point” after which GPs will no longer provide the majority of appointments because their numbers are falling so fast.

That is the conclusion of an extensive piece of new research that also shows one in five surgeries has shut and the number of patients each family doctor looks after has soared over the last decade.

It is unrealistic to expect the diminishing number of GPs working full-time to continue providing about half of all consultations, as they do now, according to the study, which has been published in the journal BMJ Open.

“Falling GP numbers delivering the same number of appointments per 1,000 patients seems unsustainable,” warn the researchers from University College London and the London School of Hygiene & Tropical Medicine (LSHTM). “Therefore there is likely to be a tipping point in the near future where the majority of appointments in English general practice are no longer delivered by GPs.”

Patients seeing a GP less often would damage the quality and continuity – defined as regular contact with the same doctor – of the care they receive, they added.

“Maintaining relational continuity of care will be harder to achieve if there is a shortage of GP appointments, and if patients need to see different clinicians for different problems this will likely have implications for quality of care,” say the team, led by Dr Luisa Pettigrew, a GP and research fellow at LSHTM.

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Source: The Guardian, 4 September 2024

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NHS faces ‘perfect winter storm’ with tenfold rise in hospital flu cases

The NHS in England is facing a “perfect winter storm” with 10 times more people in hospital with flu than this time last year, and ambulances experiencing deadly delays when arriving at A&E with sick patients.

There were an average of 344 patients a day in hospitals in England with flu last week, more than 10 times the number at the beginning of last December.

And as many as 3 in 10 patients arriving at hospitals by ambulance are waiting at least 30 minutes to be handed over to A&E teams. Health chiefs say the crisis is leading to deaths.

The figures on flu and ambulance delays were published by NHS England on Thursday and offered the first weekly snapshot of how hospitals are performing this season.

Matthew Taylor, the chief executive of the NHS Confederation, which represents the healthcare system in England, said: “These figures really hammer home just how stretched services already are as we head into a perfect winter storm. Significantly higher numbers of people are in hospital because of flu compared to this time last year, coupled with the fact that Covid-19 has not gone away.”

He added: “The life-saving safety net that NHS ambulance services provide is being severely compromised by these unnecessary delays, and patients are dying and coming to harm as a result on a daily basis.”

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Source: The Guardian, 24 November 2022

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NHS faces ‘avalanche’ of demand for autism and ADHD services, thinktank warns

The NHS is experiencing an “avalanche of need” over autism and attention deficit hyperactivity disorder (ADHD), but the system in place to cope with surging demand for assessments and treatments is “obsolete”, a health thinktank has warned.

There must be a “radical rethink” of how people with the conditions are cared for in England if the health service is to meet the rapidly expanding need for services, according to the Nuffield Trust.

The thinktank is calling for a “whole-system approach” across education, society and the NHS, amid changing social attitudes and better awareness of the conditions. It comes days after the NHS announced a major review of ADHD services.

Thea Stein, the chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand for autism assessments and ADHD treatments have completely overtaken the NHS’s capacity to meet them. It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand.

“We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer while they wait.”

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Source: The Guardian, 4 April 2024

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NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn

The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures.

Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK.

In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”.

Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone.

NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay.

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Source: The Guardian, 29 January 2023

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NHS eye care delays put complex cases at risk

Patients with complex eye conditions risk losing their sight due to delays in NHS treatment, medical experts and campaigners have warned. They say the system is under strain as independent providers prioritise simpler and more lucrative procedures.

Dr Ben Burton, the president of the Royal College of Ophthalmologists, said NHS ophthalmology services are "on the brink of collapse".

Labour MP and former surgeon Dr Peter Prinsley warned that some regions could become "ophthalmic deserts" due to inadequate coverage.

The crisis is partly driven by a rise in fees paid by the NHS to independent providers for cataract surgery in recent years, according to Prinsley. The speed of basic cataract procedures means several can be carried out in a day by consultants, which has proven lucrative, he added.

This has led to increasing numbers of NHS consultants taking on more private work, including setting up clinics near hospitals which can carry out work for the NHS, he told the Press Association (PA). It means fewer NHS appointments are available for patients with more complex conditions, such as glaucoma or macular degeneration.

Burton said the problem was reaching a crisis point, telling PA: "We're heading off a cliff, it's not sustainable, and it's not safe. It's been something I think somebody needs to take a step back on and see the bigger picture of."

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Source: Medscape UK, 3 March 2025

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NHS enters winter with ambulance delays almost double those in 2023

The time spent by ambulances stuck outside A&Es waiting to hand over patients has nearly doubled since last year, the first NHS “winter situation report” has revealed.

The first set of data from NHS England for the 2024-25 winter also reveals a huge increase in cases of flu and norovirus, and the highest-ever level of bed occupancy at this time.

The “sit rep” data shows 15.7 per cent of all patient handovers took more than an hour last week. This equates to more than 2,000 people a day being stuck in an ambulance for more than an hour while waiting for transfer to A&E.

NHSE described the pressure on ambulance services as “incredibly high”, with hours lost to ambulance delays up 87 per cent compared with last year. It said more than 35,000 hours overall had been lost to handover delays, with around 8 per cent more patients arriving by ambulance.

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Source: HSJ, 5 December 2024

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NHS England’s plans to replace traditional GP referrals

An NHS England document has confirmed that that it wants to ‘optimise’ GP referrals to secondary care via an enhanced model of advice and guidance.

GP leaders recently raised concerns that NHS England had encouraged Integrated Care Boards (ICBs) to adopt the ‘advice and refer’ model, effectively replacing traditional GP referrals and adding barriers for patients in accessing secondary care. 

At the time, NHS England did not address concerns about this specific model, but Pulse has now seen a ‘framework’ document which encouraged local commissioners to ‘strengthen’ specialist advice services in order to ‘optimise’ referrals. 

The guidance suggested the use of the ‘advice and refer’ model, which means all referrals or advice requests from GPs ‘come in through one route’ and directly bookable appointments are ‘discouraged or removed’.

Under this service, all referrals are then ‘triaged’, allowing hospitals to reject referrals and send them back to GPs with advice. 

This mechanism removes the option for GPs to send standard referrals, whereas the usual model of advice and guidance (A&G) allows GPs to seek advice if they wish, but maintains the direct referral route.

NHS England emphasised its commitment to empowering regions to ‘develop diverse models’ of specialist advice in line with their local needs.

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Source: Pulse, 26 June 2024

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NHS England’s list of trusts with worst elective and cancer problems

Almost a third of acute trusts have been identified by NHS England as being ‘at risk’ of missing key targets for electives and cancer recovery, with some facing “periodic calls between ministers and CEOs”, HSJ can reveal.

NHS England has identified 39 acute trusts at the most risk of missing the targets of having no patients waiting 78 weeks or more for elective treatment by April 2023, and returning the 62-day cancer waiting list to pre-pandemic levels by March 2023.

HSJ can reveal the full lists of 19 trusts placed in “tier one” – the most at-risk category – and 20 in “tier two” (see lists below). 

The “at risk” trusts represent 31% of the acute providers in England, with many of them among the lowest performers in the country for elective and cancer recovery.

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Source: HSJ, 19 August 2022

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NHS England: Pelvic floor physiotherapy will see improved services by March 2024

Far too many women were rushed into mesh sling surgery for stress incontinence after birth when pelvic floor physiotherapy could have fixed or eased the problem.

In France, women are offered pelvic floor physiotherapy after childbirth as standard.

A recent question to the Secretary of State for Health and Social Care asked what assessment the Department has made of the potential benefits of offering new mothers pelvic floor physiotherapy.

This question was answered on 15 November 2022:

"The National Institute for Health and Care Excellence’s guidance recognises that physiotherapy is important for the prevention and treatment of pelvic floor problems relating to pregnancy and birth. The NHS Long Term Plan committed to ensure that women have access to multidisciplinary pelvic health clinics and pathways in England.

NHS England is deploying perinatal pelvic health services to improve the prevention, identification and access to physiotherapy for pelvic health issues antenatally and postnatally. Two-thirds of local maternity and neonatal systems are expected to establish these services by the end of March 2023, with full deployment in England expected by March 2024."

Source: Parallel Parliament, 15 November 2022

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NHS England: Hospitals must ‘surge’ ICU so other regions don’t have to ration care

NHS England has asked hospitals across the country to open hundreds more intensive care beds so they can take in patients from the hardest hit areas, to prevent those patches having to ration access.

A letter sent to dozens of acute trusts today by NHS England asks them to enact their “maximum surge” for critical care from tomorrow, opening up hundreds of beds, which will rely on them redeploying staff and cancelling more planned care.

The letter is to trusts in the Midlands but HSJ understands a similar approach is being taken in the other regions where critical care is not currently under as much pressure as London, the East of England and the South East.

The message to surge capacity to support a “national critical care service” was reinforced to trusts nationwide in a call with Keith Willett, NHS England covid incident director, also on Wednesday.

The letter, from the NHSE Midlands regional team, said there had been a national request for the region to surge beyond its own needs to support London and the East of England. “Significant” numbers are likely to be transferred, HSJ was told.

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Source: HSJ, 13 January 2021

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NHS England workforce plan delayed amid rumours of cost issues

NHS leaders have raised concerns about the delay to the long-awaited workforce plan, after the health secretary, Steve Barclay, refused to give a deadline for its publication and with rumours suggesting it is considered too costly.

The plan, which was expected to be published on Tuesday, appears to have been delayed, according to the deputy chief executive of NHS Providers, Saffron Cordery.

Barclay blamed the pandemic and “various things that have been happening in recent years” for the delay during broadcast interviews over the weekend. He had previously promised that the plan to increase the number of doctors and nurses would be published before the next general election.

Cordery said the plan, which aims to fix the UK’s crumbling healthcare system by plugging chronic staff shortages but which has already been postponed from last year, was needed “as quickly as possible”.

Until this weekend NHS Providers – which represents all England’s hospital, ambulance, community and mental health trusts – had believed publication of the plan was “imminent”. Cordery suggested that the failure to release it could be linked to the need for funding.

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Source: The Guardian, 29 May 2023

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NHS England whistleblowing takeover ‘will have chilling effect’

NHS England’s plan to take over a key whistleblowing initiative will have a “chilling effect” on staff wishing to speak up, experts have warned.

NHSE and individual trusts will take on the oversight of Freedom to Speak Up arrangements from the summer, following Penny Dash’s recommendation last year to disband the National Guardian’s Office as part of her government-commissioned patient safety review.

New guidance says that, from July, NHS England will support existing guardian networks and individual guardians. This includes NHSE staff designated as “experts” providing confidential one-to-one support.

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Source: Health Service Journal, 21 April 2026.

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NHS England warns against block cancellations during ‘unprecedented’ strikes

NHS England has told trust, system and regional leaders to avoid “block rescheduling” of elective cases during the four-day junior doctors’ strike next month.

In a letter sent by national medical director Sir Steve Powis and NHSE’s chief operating officer Sir David Sloman, NHS leaders are asked instead to use “rolling day-to-day cancellations” and reschedule cases “based on clinical risk”.

The letter also urges leaders to maintain “as much day case and outpatient capacity as possible” and to use digital or virtual consultations to support outpatient delivery. However, it acknowledges that because of the “unprecedented scale and timing of these strikes we accept that rescheduling activity is going to be essential to minimise risks to patients”.

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Source: HSJ, 31 March 2023

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NHS England waiting times for gender dysphoria patients unlawful, court hears

NHS England has acted unlawfully by making thousands of patients with gender dysphoria wait “extreme” periods of time for treatment, the high court has heard.

Transgender claimants, who have suffered distress as a result of delays, want the court to declare that NHSE broke the law by failing to meet a target for 92% of patients to commence treatment within 18 weeks.

NHSE figures show there are 26,234 adults waiting for a first appointment with an adult gender dysphoria clinic, of whom 23,561 have been waiting more than 18 weeks. The number of children on the waiting list is approximately 7,600, of whom about 6,100 have been waiting more than 18 weeks.

In a witness statement, one of the claimants, Eva Echo, said she received a referral in October 2017 but had still not been given a first appointment, leaving her in “painful indefinite limbo”. A co-claimant, Alexander Harvey, who has been waiting for a first appointment since 2019, said the delay “means that I have to continue to live in a body which I don’t feel is mine and which does not reflect who I am”. He said he had twice tried to kill himself.

In written submissions for Tuesday’s hearing, David Lock KC, representing the claimants, said delays to puberty-blocking treatment – the current waiting time for children to access services is more than two years – could cause “intense anxiety and distress” to adolescents as a result of them experiencing “permanent and irreversible bodily changes”.

While NHSE accepts it has not met the 92% target across the cohort of patients for whom its health services are commissioned, it claims a breach does not give rise to enforceable individual rights.

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Source: The Guardian, 29 November 2022

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NHS England waiting times for cancer referral and treatment at record high

The numbers of cancer patients facing delays in seeing a specialist for the first time and starting their treatment have hit record highs in England, amid fears that overstretched NHS services can no longer provide prompt care.

The disclosure comes as a new row over how quickly hospitals can clear the record 6 million-strong NHS backlog has forced ministers to delay publication of the long-awaited plan to tackle it.

Half a million people in England with suspected cancer will have to wait longer than the supposed two-week maximum to see an oncologist this year, an analysis for the House of Commons library reveals.

The number of patients confirmed to have the disease who are unable to start treatment such as surgery or chemotherapy within the 31 or 62 days that hospitals try to guarantee is expected to exceed 75,000 for the first time.

Experts, who claim significant shortages in the NHS cancer workforce are to blame, fear delays in getting diagnosed and starting care could reduce a patient’s chances of survival. Cancer charities highlighted the “unimaginable distress and anxiety” they induce in patients.

“Cancer care is in crisis,” the shadow health secretary, Wes Streeting, said. “As this new analysis shows, terrifyingly large numbers of people are waiting longer than they should to receive vital cancer care and treatment with the insecurity of not knowing.”

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Source: The Guardian, 6 February 2022

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NHS England urgently appeals to GPs to staff triage service

A key element in the new covid-19 response service run by NHS 111 urgently needs more doctors, NHS England has said.

The national covid-19 clinical assessment service, or CCAS, serves a cohort of patients with coronavirus symptoms deemed by 111 as needing a clinical assessment over the phone or online.

An email to GPs from NHSE’s primary care directors on Friday evening said: “We urgently need more GPs help to staff this service, especially as covid-19 cases increase over coming days, because of your expertise and experience.”

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Source: HSJ, 6 April 2020

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NHS England urged to introduce external second opinion when dismissing staff

NHS England is being urged to introduce an independent second opinion whenever it decides to dismiss a healthcare professional, in memory of a nurse who set himself on fire after being unfairly dismissed from his job.

Dr Narinder Kapur, an NHS whistleblower, is proposing “Amin’s rule”, named after Amin Abdullah, who killed himself in 2016, to plug a gap he says exists when it comes to staff wellbeing.

Kapur, 76, a consultant neuropsychologist and visiting professor at University College London, was sacked by Addenbrooke’s hospital in Cambridge in 2010 after raising concerns about staff shortages and unqualified staff working without proper supervision.

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Source: Guardian, 4 January 2026

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