The patients that the NHS forgot

Rosa Silverman and Cara McGoogan report on how illnesses other than coronavirus are going untreated – with fatal results

Back in February, Francis Phillips woke in the night with severe chest pains. Over the following few weeks, they persisted, so he visited his GP surgery and had an electrocardiogram to check his heart. The results were abnormal and he was told he would need to see a specialist.

By this time, however, the UK was facing a public health crisis, the response to which would end up causing unquantifiable damage. As treating – and beating – Covid-19 became the NHS’s top priority, routine appointments were cancelled, treatments suspended, and waiting lists grew and grew, across the board.

By May, still awaiting an appointment, Phillips’s continuing pain led to him being taken by ambulance to hospital, where he was told he needed an urgent echocardiogram. But in early June, after countless follow-up phone calls, he finally received a letter from Gloucestershire Royal Hospital informing him that routine appointments were not being offered, to reduce the risk to patients.

“I can’t understand why everything else has come to a standstill,” says the 72-year-old, who has still not been seen. “I don’t like to run the NHS down because they do so many good things, but I’m clearly not the only one in this position.”

This is manifestly the case. Official data released on Thursday revealed the true scale of the damage done to NHS waiting lists by the coronavirus crisis: showing that the number of patients admitted for routine treatment in hospitals in England was down 82 per cent in May compared with a year ago, reversing more than 13 years of progress. In particular, experts warn of a growing crisis in access to diagnostic procedures, with 571,459 patients waiting more than six weeks in May for one of 15 standard tests, including MRI and ultrasound, compared to just 43,230 in the same month last year.

Last week, Phillips was told he would receive a letter about his appointment within two weeks. So, along with hundreds of thousands of others, he continues to wait.

When Telegraph columnist Allison Pearson highlighted last week the “dire” experience of many non-Covid NHS patients, countless readers got in touch to describe heartbreaking struggles: cancer patients denied treatment; a woman with fibroids in her womb who needed an urgent hysterectomy but has spent lockdown bleeding, in constant pain, after her surgery was cancelled; others with heart problems or agonising joint pain, yet no prospect of being seen. Lives diminished and, in the worst cases, lost.

Some wanted to share their stories anonymously, for fear of jeopardising their relationship with their doctors. One, a magistrate from Essex in her 50s, says her husband has waited in vain for diagnosis of a bladder problem. “He went to the GP at the beginning of the year and was sent for ultrasound and urine tests,” she says. “Then he was referred to a urologist in February, but his hospital appointment was cancelled and replaced by a phone appointment.

“The consultant had no access to his scan or any of his medical records, so could only suggest that all the tests were redone. He’s still not had a diagnosis, and if he’s dying of bladder cancer, I fear he isn’t going to be treated. I feel really angry – it feels like they’re focusing so much on Covid, other deaths aren’t being factored in.”

Patients’ groups raise similar concerns. Diagnostic services, medicines, dental services and GP appointments have all been difficult to access, they report; illnesses other than coronavirus are therefore being missed.

“The NHS’s titanic response to Covid-19 was achieved by cutting care and other services such as diagnostics for patients whose needs, in the face of the pandemic, were considered less urgent by the system,” says Rachel Power, chief executive of the Patients Association. “There is a clear risk of some patients suffering avoidably poor outcomes compared to what they could have expected under normal circumstances.”

Some have welcomed the opportunity to contact a GP online or on the phone without going into a surgery. But for those less confident using technology, or for those with complaints that require a physical examination, not to mention hospital treatment or therapy, the new system clearly doesn’t work.

Age UK says it has heard from older people whose lack of ready access to their GP has been “a real source of concern in recent months”, leaving them struggling to manage their health.

Caroline Abrahams, the charity’s director, says: “Some have found new online or telephone systems particularly difficult to navigate, especially for those with hearing problems or cognitive decline. The majority of the 70-plus population is not online at all. It’s essential that older people who need and want face-to-face appointments can still get them.”

Doctors are often deeply uneasy that an emergency system designed for the coronavirus peak is still in effect. “One of my patients goes in and out of an irregular heartbeat and could suffer a stroke,” says one London-based GP. “The cardiology team has said she needs a 24-hour monitor, but it’s impossible to get them.

“This woman is in her 60s and is really fit and well. If she has a stroke, it would have been 100 per cent preventable, plus it would probably cost the Government about £1million in treatment and rehabilitation. It’s so short-sighted. It makes no sense that you can open pubs but you can’t help patients like this.”

Meanwhile, coronavirus infection rates have slumped to a fraction of what they were. The latest ONS figures estimate that an average of one in 3,900 within the community in England had the virus at any given time between June 22 and July 5. So why, then, has the healthcare system not shown more signs of returning to normal?

“The NHS is renowned for being slow and resistant to change,” says the GP. “At the start of the crisis, everyone was energised and pumped. Now people are tired and fed up. I guess it’s much easier to design a system where you’re quickly taking things away, than one in which you’re putting things back in place but with lots of new safety measures. But GP surgeries have been given extra funding to cope during the crisis. There is money sloshing around.”

A London-based consultant, who also asked for anonymity, suggests that a desire to cut costs could be to blame.

“Most of us are completely frustrated by not being able to deal with people face to face,” she says. “It’s not us who are refusing to do that. There seems to be very little humanity in the whole thing. You can’t safely practise medicine like this.” Multiple harrowing stories back this up. One woman, a 60-year-old retired doctor living in Wales, recounts how her mother was suddenly ejected from hospital at the start of the crisis while suffering from terminal cancer: “They put her in a hospital tracksuit and sent her home with some painkillers and no support. Four days earlier, she’d been told all her needs would be assessed before she was discharged. That didn’t happen.”

Sherwin Hall, a 27-year-old father of two, was diagnosed with a rare and aggressive form of cancer last month having begged for a CT scan at the start of lockdown and believes his diagnosis was delayed by the crisis. “If I was scanned the first time I went to hospital, I would be 60 or 70 per cent ready to watch my son grow up and ready to live life. It would have been a primary tumour, they could have cut it out and given me chemotherapy and I’d have had a very good chance of surviving.

“I’m on chemotherapy now. There’s a 15 per cent chance that it works. If it doesn’t, then I’ve got three months to live. Every day I think ‘why didn’t they give me a scan?’ It would have taken two seconds to save my life.”

The NHS has defended its record, with a spokesman saying that, despite coronavirus, staff had “provided more than five million urgent tests, checks and treatments in a safe way during the peak of the virus, with over 65,000 people starting cancer therapy”.

“NHS services continue to be available for those who need it and staff continue to work hard to bring back as many non-urgent tests and treatments as possible, but the reality is that while Covid-19 still poses a threat… extra care will need to be taken for the safety of individuals, other patients and our staff,” they said.

But Deborah James, a co-presenter of the You, Me and the Big C podcast who was diagnosed with bowel cancer at 35, says: “People feel pushed aside, like cancer has been given a massive back seat. Everyone recognises Covid is a problem, but we can’t forget more people are dying every day now of cancer than of Covid.”

As the GP observes, it is “painfully obvious” how dire the situation has become. When the tragic numbers are finally totted up, excess deaths from cancer, heart disease and stroke could easily outstrip those from Covid-19, thanks to a healthcare system that has thrown everything at the virus – but left everyone else in the cold.

‘If I’d had a scan, I’d have had a good chance of survival. Now, I’ve probably got three months to live’