The scale of NHS England’s failure to deliver a functional health service can be laid bare today after Keir Starmer sounded its death knell.
The PM has declared that the ‘world’s biggest quango’ will be scrapped to restore ‘democratic control’ and slash red tape.
The body will be folded into the Department of Health, potentially allowing 10,000 jobs to be cut and freeing up cash for frontline services.
Established in 2013 under the Coalition government , NHS England was intended to give health service policymakers independence and autonomy from politicians.
Yet in the words of one medical critic today, it rapidly became little more than ‘an overblown bureaucratic folly’.
Despite a gargantuan near-£200bn budget at its disposal, NHS waiting lists have ballooned, while productivity and patient satisfaction has crashed to record lows.
GP services are faltering, and lives have being put at risk daily due to dangerously long ambulance delays and failures to provide speedy cancer treatments.
Staff shortages are also spiralling with more than 8,000 unfilled doctors posts and 27,000 nursing vacancies, according to the latest figures.
Here, MailOnline illustrates the data that shows, in stark relief, how NHS England has presided over the steady decline of health services — and why few will mourn its passing.
NHS waiting lists
In 2013, when NHS England was created, the waiting list for routine operations like hip and knee replacements stood at 2.3 million. By February 2020, it had risen to 4.6 million.
The dawn of the pandemic saw the body stop swathes of routine care, with far more surgeries axed than other nations battling Covid.
Latest figures released yesterday show while the total number of NHS procedures that people are waiting for has fallen, it still stands at 7.43 million.
This is equivalent to 6.25 million individual patients, with some people waiting for more than one operation.
More than 2,000 patients had been stuck for more than 18 months to start treatment, while almost 15,000 had been left over 65 weeks.
However, the figures are still below the record peak of 7.77 million treatments and 6.5 million patients recorded in September 2023.
People who are stuck in the queues for such procedures often live in pain or discomfort while they are forced to wait, some taking painkillers to cope, with many are unable to work.
A&E waits
Delays of four and even 12 hours have become routine in NHS emergency departments.
Patients have been forced to sit in chairs or on the floor for days at a time and receive undignified corridor care.
Internal NHS England targets state that 95 per cent of patients should be seen within four hours — but this haven’t been met since 2015.
Even that was blip, with the target was last consistently met the year prior.
In January this year a record number of patients, 61,529, were forced to wait at least 12 hours for emergency care.
The number waiting at least four hours in A&E was 159,582 in January.
In comparison, less than 20,000 four hour waits were recorded prior to 2013.
NHS England publishes data on what are known as trolley waits — the time between a medic deciding a patient needs to be admitted to hospital, and when they are given a bed.
Critics claim this underestimates the scale of the problem as it does not tally the total time a patient spends waiting in A&E, from the point when they arrive.
Meanwhile, analysis by the Royal College of Emergency Medicine suggested delays in A&E caused more than 250 deaths per week in 2023.
Ambulance response times
Ambulance response times have increasingly failed to meet NHS targets.
In some months, victims of strokes and heart attacks have been forced to wait over an hour for help, triple the health service’s target.
Official data shows such extraordinary waits have grown increasingly common over time.
For Category 1 calls, which cover the most life threatening for issues like a cardiac arrest, ambulances should arrive within seven minutes.
This target has been met only a handful of times in 2019, with average waits of almost 11 minutes recorded in some months in 2022.
Responses for Category 2 calls, the next most urgent and which include emergencies like heart attack and strokes, have suffered the greatest performance gap.
NHS England states an ambulance should arrive to such a call within 18 minutes, on average, a target which hasn’t been met since August 2017 when response times were about 20 minutes
But in some months in 2022 and 2023 such patients have been forced to wait, on average, more than hour for ambulance, more than triple the target.
Targets for category 3 calls, which cover urgent medical issues like severe abdominal pains, have repeatedly failed to be met.
The NHS states such calls should be responded to within two hours. This target consistently met until late 2019.
However, between 2021 and 2022 such patients had to wait up four hours on average for an ambulance. The target has failed to be met since.
Both Sir Keir and health secretary Wes Streeting argued the move would benefit NHS staff and patients. Pictured, Mr Streeting with outgoing NHS chief executive Amanda Pritchard
Delayed discharges
Delayed discharges are patients who are medically fit to leave to hospital but unable to do so due to a lack of space in care homes or few available community care staff.
Colloquially known as ‘bed-blockers’, these patients take up an NHS bed which has a cascading impact on other parts of the health service.
Being unable to free up these beds means elective operations are delayed, exacerbating problems with waiting lists.
It’s also a huge driver of A&E waits and ambulance handover delays as there are fewer free beds for incoming patients to be transferred to.
Analysis suggests more than 12,000 hospital beds every day are occupied by patients unable to leave, equivalent to closing 26 entire hospitals.
Figures also suggest the problem is getting worse. An average of 8,000 bed blockers were recorded per day in April 2021.
The figure for April 2024 was 12,800 per day, a rise of almost 60 per cent.
Cancer delays
Cancer performance figures, too, show NHS England is still failing to meet targets.
Just one of its three monthly targets has been hit a handful of times since they were all put in place in 2021.
Latest data for January reveals just 67.3 per cent of newly-diagnosed cancer patients referred for urgent treatment were seen within two months — the target is 85 per cent.
Meanwhile, only 88.8 per cent of patients started treatment within 31 days of being booked in December, below the goal of 96 per cent.
The health service target of telling at least 75 per cent of patients with suspected cancer they do or don’t have the disease also wasn’t met, logging a figure of 73.4 per cent — unchanged on early 2021 when this statistic was first tracked.
It is also the only figure of the three to have previously met the target — nine times out of 46.
Fast access to cancer care not only reduces the chance of the disease spreading to other areas of the body, it can also mean a patient doesn’t need as extensive treatments like chemotherapy or radiotherapy or for as long.
But NHS England bosses have long argued they are seeing more patients than ever as part of the fight against cancer, despite a slump in performance.
Survival rates are also at an all-time high thanks to medical advances and schemes, such as pop-up diagnostic centres in shopping centres, which are designed to spot the disease early, when it is easier to treat.
Seeing a GP
Patients have grown increasingly frustrated about poor access to their family doctors.
A particular sore point has been increasing difficulties seeing a GP face-to-face and not via a remote consultation in the wake of the Covid pandemic.
During the crisis NHS England implemented a system of ‘total triage’ meaning patients could only access GPs remotely in the first instance, before being able to see them in person if needed.
Consequently, the proportion of face-to-face appointments collapsed to about four in 10.
Before the crisis eight out of 10 appointments were held in person.
Despite being years past the pandemic the figure has failed to recover to its pre-Covid highs.
Currently about six in 10 NHS GP appointments are held face to face in England.
The time it takes to see a GP has also remained stubbornly high, only four in 10 patients are able to see their family doctor on the same day.
Patient satisfaction
As waiting list backlogs have grown, public faith in the health service has plummeted.
Last year, the British Social Attitudes survey found that less than a quarter of people were satisfied with the way the NHS is running — down 5 percentage points on the previous year alone.
It was also the lowest figure in the 41-year history of the survey.
The study, of 3,374 people in England, Wales and Scotland, is seen as the gold-standard test of how people feel about the NHS.
Yet, the survey also found that despite the challenges patients faced, they did not want to change the model of the NHS.
They simply wanted the one they have got to work, with improvements in waiting times for services, funding and the number of NHS staff.
Diagnostic waiting times
Diagnostic tests, scans and procedures are critical to detecting, diagnosing and predicting the likelihood of many diseases, including cancer.
Since 2008, the health service’s aim has been to diagnose patients within six weeks of them being referred for further testing.
But wait times for diagnoses have also risen under the rein of NHS England.
In fact, the number of patients waiting more than six weeks for NHS diagnostic checks soared 23-fold in less than a decade, data released in December 2024 showed.
These delays can prevent doctors from prescribing drugs or performing surgery, during which time conditions can worsen and potentially become incurable.
The overall NHS waiting list for diagnostic checks, including MRI and CT scans, currently stands at a record 1.6million, NHS England figures show, almost double the number waiting in July 2015.
Of these, 22 per cent — 364,544 people — have been waiting over six weeks.
Figures released by NHS England last week showed improvement on diagnostic wait times in recent months.
While they failed to meet their new target of a 28-day faster diagnosis, the number of patients given a definitive diagnosis for cancer or the all clear within four weeks increased on the previous month.