The most recent NHS England statistics show the numbers in the queue for elective treatment has now topped 6.7 million – more than one in eight of the population – with over 350,000 waiting over a year.

Within this the Telegraph has flagged up the large and growing number of children waiting for hospital treatment, which has risen by almost 50 per cent in a year to a record high of 361,000 – and is now increasing at a rate of 10,000 children per month.

But this is just for acute services. The HSJ in August also revealed a hidden 1 million-strong additional waiting list for even more poorly-resourced community health services, among them

  • 75,000 children waiting to access community paediatric services, “including children needing help with developmental delay, long-term health conditions and additional needs”;
  • 74,300 young people waiting for speech and language therapy.
  • 321,000 adults waiting for musculoskeletal services, mostly physiotherapy;
  • and 120,000 waiting for podiatry.

On top of this there are long delays for children needing mental health treatment and support, including the rising number requiring specialist treatment for eating disorders. Relatively few statistics appear to be collated for timely access to adult mental health services, but the most recent mental health dashboard shows that despite rising demand for support, spending on mental health services as share of commissioning budgets fell back last year to 2018/19 levels.

What has been the response to this latest evidence of crisis? Locum Health Secretary Steve Barclay has tried to assure a servile Telegraph interviewer that Health and Social care is not one of the government’s zombie departments treading water until the new Prime Minister is announced.

But his interview is a succession of exaggerated claims and zombie ideas that show he has little if any contact with, or experience of the real world.

He insists everything is being done “at pace” and that the DHSC is in a “real sprint to get ready for September” – but is unable to identify decisions that are being made, other than to come back again and again to the issue of hiring more staff from overseas.

It’s not at all clear Telegraph readers and that those who voted Tory in 2019 to ‘get Brexit done’ and reduce immigration will be delighted to find out that Government has had to lift the cap on healthcare visas and step up international recruitment to plug the growing gaps in the NHS workforce. They will no doubt be even less happy to hear that the European staff who have left or are no longer applying to come here have been partly replaced by Asians (India and Philippines) and Africans (Nigeria).

Barclay serves up a succession of quick fire nonsense ideas which display a near-complete ignorance of the way the NHS works and indifference to the consequences of his proposals:

  • Using “technology and data” to take pressure off surgeries and A&E – claiming this would somehow “rid the service of layers of middle-management bureaucracy.”
  • He goes on to suggest “Some routine appointments such as those to measure blood pressure,” which Barclay appears to believe are currently done by GPs “could be carried out by pharmacists” (indicating he has not joined any of the queues at local pharmacies recently) and “booked on the NHS app” (ignoring the high level of digital exclusion among many of the patients requiring such monitoring).
  • He has apparently ordered a “digital mapping” exercise of the service’s workforce “to root out where efficiency savings can be made,” claiming without any evidence: “There’s significant scope to reduce non-front-line clinical staff by addressing areas of duplication.”
  • Acknowledging that A&E is “a very challenging landscape at the moment”, Barclay revealed he was working on a “pharmacy first model” to ease the pressure on hospitals – although exactly how pharmacists might help treat seriously ill patients needing a blue light ambulance and a hospital bed is of course left vague.
  • As if all this was not dynamic and obscure enough, Barclay said he was so concerned at the delays in ambulance services and access to emergency departments he had “set up a task force” in his department to “bring much more focus to this issue.” They will of course “work at it at pace and to see what is the scope of the opportunity”.  The thinking seems to be on a par with the genius of the £30m, 4 year contract just signed, to commission St John Ambulance volunteers to put in extra shifts supporting 999 crews … and add more ambulances to the queues outside log-jammed A&E departments. One ambulance worker has flagged up a patient still in the ambulance 25 hours after arriving at hospital.
  • But Barclay also backs Rishi Sunak’s ridiculous proposal for a £10 fine on patients who fail to attend appointments.

His entire interview consists of rehearsing abstract notions and discredited, naive ideas resting on lazy assumptions. However much this may be dressed up in a spurious claim to be taking dynamic action, the absence of any concrete or workable proposals combine with the shortage of staff and the lack of funding after more than a decade of real terms cuts adds up to complete inaction as NHS staff grapple with the real problems day to day.

What makes this worse is that NHS England is resorting to similar techniques to divert from the performance issues. While we might excuse senior figures for highlighting positive achievements in an effort to bolster staff morale (even if it might be more productive to crank up the heat on government for adequate funding) the most recent idea seems more likely to leave staff angry or bemused.

A message has been sent to trusts urging them to plan for a “Super September” of “accelerated elective recovery plans,” according to the HSJ. However on closer scrutiny it turns out the ambition is rather for a Frantic Fortnight, beginning in the last week of September.

But the far from super plan seems to be to axe follow-up appointments to make space for an increased number of first appointments for “patients who are the longest waiters who have not yet been seen”.

Exactly how adding more patients to the list is supposed to reduce the numbers waiting for treatment is not explained: it seems possible it could make things worse.

With no beds for emergency patients, insufficient staff and a massive funding gap as the elephant in the room of every Integrated Care Board meeting, this is definitely substituting words for action

The logjam of hospitals and the growing waiting lists have reached the point where ministers and NHS England bosses are no longer re-arranging the deckchairs on the Titanic, they are juggling cliches, platitudes and zombie ideas that keep resurfacing as the chaos worsens.


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