The nightmarish state of the NHS has been revealed in a series of shocking charts crafted by MailOnline, as the Prime Minister warns the service must ‘reform or die’.
Official data paints a grim picture of the service millions of Brits rely on for both emergency care and routine treatments — as well as checks that ward off long-term disease.
The fascinating analysis follows a damning report by Lord Darzi, a pioneering surgeon and former Labour health minister, which concluded the NHS is in a ‘critical condition’.
His 142-page document revealed waits for routine care and A&E have got longer, while Brits have got sicker, and progress in tackling some major conditions has stalled.
Prime Minister Keir Starmer has warned that the NHS must ‘reform or die’.
Meanwhile, the NHS is bogged down in bureaucracy and has become less productive with the money it receives, it adds.
Sir Keir Starmer has warned that NHS must ‘reform or die’ as he sets out plans for the ‘biggest reimagining’ of the service since its birth.
The Prime Minister will pledge to cut waiting times and improve access to care in a bid to tackle the nation’s ill health and get sick people back to work.
It is expected to involve shifting billions of pounds of funding from inefficient hospitals to community care, with a new focus on preventing people from getting unwell in the first place.
Here MailOnline details just some of the challenges ahead that impact millions of people across England.
NHS Waiting lists
The total number of NHS procedures, like hip and knee replacements and cataract surgery, that people in England are currently waiting for hit 7.62million in July, the latest figure available.
This is the same figure as the month prior and is equivalent to 6.4million individual patients, with some Brits waiting for more than one operation.
The figures are still below the record peak of 7.77million treatments and 6.5million patients recorded in September 2023, but the total has been creeping up since April.
Some 290,000, about one in 20 people on the list, have been waiting a over a year for treatment.
This is the lowest figure for such waits recorded since December 2020.
While these elective procedures are not life-saving surgeries, they improve the wellbeing of millions of people.
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, and many are unable to work.
A&E queues
Last month 76.3 per cent of patients were seen within four hours in A&Es in England.
That means roughly a quarter were waiting longer than this.
This is a slight improvement compared to the July, when 75.2 patients were seen within this timeframe.
However, it is far below pre-pandemic figures for August when 86.3 per cent of patients were seen in under four hours.
Last month’s figure is below the 78 per cent target the NHS has set to be hit by March 2025. It is now three years since A&E performance was at this level.
However, it did meet a target of 76 per cent set by the NHS recovery plan in March this year.
The number of Brits suffering agonising 12-hour waits in August decreased to 28,494, down from 36,806 in July.
August’s figure is equivalent to 8.6 per cent of all patients, which is worse than the same month last year when 8.3 per cent of patients had to wait in excess of 12 hours.
The number of ‘trolley waits’, which represents the time between doctors deciding a patient needs to be admitted and the actually getting a bed, has shown some signs of improvement.
Only 36,806 such waits, where patients can experience undignified ‘corridor care’, were recorded in July, the latest figures available for this metric.
This is a fall from just over 38,000 recorded the month prior.
Ambulance response times
It has been four years since a national average 18-minute response time for ambulances to arrive to emergencies has been met.
The current average response time for such emergencies in England is now 27 minutes and 25 seconds, according to data for August.
However, the data shows some Brits are still waiting almost an hour for an ambulance to arrive for emergencies like heart attacks and strokes.
Whilst still far above the 18-minute target, August’s performance data is better than the month prior when ambulances took an average of 33 minutes 35 seconds to arrive.
Performance for category one ambulance calls, the most serious and which include emergencies like someone’s heart having stopped, was also below target.
It took ambulances an average of 8 minutes and 3 seconds to arrive to such emergencies. The target is 7 minutes.
Quick responses to emergencies and getting patients the help they need as fast as possible improves the odds of survival and reduces the chances they could suffer debilitating complications.
Cancer delays
One in two Brits are estimated to get cancer at some point in their life.
But despite the critical importance of fast access to diagnosis and treatment in improving outcomes NHS performance is still far below targets.
Data shows the proportion of patients being treated within two months of an urgent cancer referral was only 67.4 per cent in June. The target is 85 per cent and has never been met.
In human terms, this meant over 8,000 of cancer patients in England had to wait more than 62 days to start treatment.
June’s figure was an improvement on May’s, when only 65.8 per cent of patients were seen in this time frame but a decline on March’s when the figure was 68.9 per cent.
Other cancer performance figures are failing or only just managing to meet targets.
Only 90.9 per cent of patients started treatment within 31 days of being booked in June, below the goal of 96 per cent.
But an NHS target of telling at least 75 per cent of patients with suspected cancer they do or don’t have the disease was met for the second month running.
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.
GP crisis
The number of doctors’ surgeries have fallen by a fifth over the last decade while patient numbers have leapt by 40 per cent.
But while overall practice staff levels has increased with demand, the number of GPs per 1,000 patients fell by 15 per cent.
People registered with an NHS GP practice in England grew 11 per cent, rising from 56,042,361 to 62,418,295 between 2013 and 2023.
Meanwhile, the total number of GP practices fell from 8,044 to 6,419 over the same period – a 20 per cent drop.
While the general practice workforce increased by 20 per cent, actual GP numbers have not risen in line with population growth. Additionally, an increasing number are working part-time.
Overall, full-time GP numbers fell from 27,948 to 27,321, according to the findings published in the BMJ.
This means there are now 0.45 GPs per 1,000 patients, down from 0.53 a decade ago.
The struggle to access GP appointments is a complex problem, with doctors themselves reporting being overwhelmed by patient demand.
Under guidelines GPs are told not to deliver more than 25 appointments a day to ensure ‘safe care’. But some doctors are reportedly having to cram in nearly 60 in every work day.
The result is millions of patients being rushed through appointments, which critics have described as being treated like ‘goods on a factory conveyor belt’.
Struggling to access timely GP appointments also has knock-on effects for other aspects of NHS care like A&E, with patients unable to get their health issues seen at the primary level seeking help from emergency departments.
Spending
While crying out for the need to reform the NHS, Labour has yet to unveil its spending plans for the health service.
The NHS last got a budget boost in March when then Chancellor Jeremy Hunt handed the service an extra £3.5billion for outdated IT systems.
This came hand-in-hand with an extra £2.5bn to ‘meet pressures for the coming year’ and tackle waiting lists, taking the total announced investment to almost £6bn.
The extra funding took the NHS budget for the financial year to almost £165billion.
However, despite the huge budget the NHS receives, reports have found that is increasingly less efficient.
Labour is expected to reveal any additional funding plans for the NHS at October’s budget.
Crumbling hospitals
One ever-growing weight on the NHS is the expanding maintenance backlog which references works like repairing crumbling buildings.
The latest NHS data, for 2022-23, shows this figure is now a whopping £11.6billion, up from £10.2billion the previous year.
This represents work the health service classifies as ‘should have already been done’ rather than regular maintenance work.
Of the £11.6billion figure, £2.6billion is classified as ‘high risk’ with this section of the repair backlog growing 31 per cent in value over the year.
For context, ‘high risk’ in NHS maintenance terminology means works that are urgently needed to prevent ‘catastrophic failure’ which could result in disruption to services or even risk patient safety.
Public satisfaction
The public’s satisfaction with the NHS has fallen to the lowest level on record amid poor access to GPs and long waits for hospital care.
Fewer than one in four (24 per cent) people were happy with the health service in 2023, down 5 percentage points on the previous year alone.
It is the lowest level since records began in 1983, according to latest findings from the British Social Attitudes 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.
It reveals more than half (52 per cent) are now dissatisfied with the NHS, the highest proportion since the survey began.
NHS dentistry
Brits continue to struggle to access affordable NHS subsidised dental care.
Latest official data shows just 40 per cent of adults have in England have seen an NHS dentist in the last two years as of June this year.
This compares to almost 50 per cent in late 2019, just before the Covid pandemic forced many dentists to temporarily shut their doors as the nation went into lockdown.
For children, who have free access to health service dental care, the proportion of those who have seen an NHS dentist in 12 months has fallen to 56 per cent in June this year. This down from almost 60 per cent pre-pandemic.
NHS dentist attendance figures for both adults and children dived off a cliff during the Covid pandemic as practices shut as part of lockdown rules and stopped offering treatments.
But it has failed to bounce back despite the darkest days of the pandemic being well in the past.
Industry experts suggest this is because offering NHS treatment is not as lucrative as going private.
Old NHS contracts for dentists paid them for batches of work carried out rather than for individual treatments, regardless how complicated a particular case might be.
In practice, this meant NHS dentists were paid the same for treating a patient that needed 10 fillings as a patient that needed just one.
This resulted in dentists losing money from treating some NHS patients as what they were paid didn’t cover the costs of doing the procedure.
While this contract has now been reformed, the British Dental Association (BDA) estimates thousands of NHS dentists abandoned or vastly scaled back their NHS work post-pandemic.
Compounding the crisis is that as more dentists ditch or vastly reduce their NHS work, those who remain risk become overwhelmed.
Mental health
The number of Brits seeking help for mental health issues like depression and anxiety has soared in recent years.
NHS data for England shows over 3.5million people are now in contact with health service mental health teams, up from 2.5 million five years ago.
Separate data also shows the health service waiting list for an autism assessment is the longest since current records began five years ago.
Charities warned the lengthy waits can be damaging to patients and called for urgent action to meet the rise in demand.
Figures released by NHS Digital shows both the total number of waits for an assessment and waits longer than 13 weeks are the highest they have been since data collection started.
Last December, 172,040 people were waiting for an assessment, up from 117,020 a year earlier and more than five times the 32,220 in December 2019.
