Watchdog shines light on ‘serious impact’ of cancelled care

Patients are facing ‘catastrophic health impacts’ due to vital appointments being postponed and cancelled, a watchdog has warned. Healthwatch England said that last-minute cancellations were leading to people’s symptoms getting worse and causing their mental health to deteriorate. Some are facing multiple cancelations and postponements, it added. It comes as a poll, conducted on behalf of Healthwatch, found that more than a third (39%) of people who had an appointment called off this year experienced cancellations or postponements two or more times. Some 1,084 adults in England who had an appointment cancelled in 2023 were polled by Yonder Data Solutions on behalf of Healthwatch England. This group includes people who had faced postponements for pre-planned hospital care, hospital outpatient appointments, diagnostic scans or tests and community health appointments. Nearly one in five (18%) said their appointment was cancelled at the ‘last minute’ – either on the day or as they arrived for their appointment. Some 66% said cancellations to care had impacted their lives, reporting ongoing pain, worsening symptoms, worsening mental health, and disrupted sleep, among other problems. Half (52%) said they had not been offered support to manage their medical condition during the new wait for care and 79% said the NHS had offered them ‘very little’ or ‘no support’ with their mental health. The findings of our research show that many people are currently facing worsening and, in some cases, catastrophic health impacts due to ongoing delays to care. Louise Ansari, Healthwatch England Healthwatch said that some groups appeared to be disproportionately affected by the impact of cancellations including unpaid carers, neurodivergent people, those on lower incomes and people from minority ethnic backgrounds. And people more likely to report two or more NHS postponements include neurodivergent people, those on lower incomes, ethnic minorities and LGBTQ people, it added. In 2022/23, NHS data show that there were 77,266 last minute cancelled operations for people waiting for pre-planned care in hospitals in England. Meanwhile, NHS figures also show that industrial action in England over the last eight months has led to 819,000 appointments, operations and procedures being postponed. Only 15% of those surveyed had been told their appointment was postponed due to industrial action while 41% said they care was cancelled for another reason. The poll was released as junior doctors in England announced a fresh round of strikes in August, which could lead to upheaval for tens of thousands of additional appointments. One stroke patient described how she was told her appointment was cancelled because ‘there’s no gap for you’. On the day of her follow-up appointment with a stroke unit, Andrea Lambert, a teacher from the Isle of Wight, was told that it had been cancelled due to staff illness. ‘They just said: ‘We can’t do it, there is no gap for you’,’ the 62-year-old said. ‘They told me the earliest they could reschedule my appointment was another six weeks later.’ ‘I had a lot of questions for my stroke treatment team, but I wasn’t able to ask them.’ Louise Ansari, chief executive of Healthwatch England, said: ’The findings of our research show that many people are currently facing worsening and, in some cases, catastrophic health impacts due to ongoing delays to care. ‘And addressing health inequalities continues to be a significant challenge for the NHS. ‘ People who often face serious difficulties accessing specialist NHS care, such as unpaid carers, neurodivergent people, and those on lower incomes, are also those who are suffering the most from ongoing cancellations. ‘If their symptoms worsen or their mental health deteriorates, this in turn puts extra pressure on health and care services. ‘While we welcomed the recently announced long-term NHS workforce plan, we need to see action to tackle the cycle of high patient need and ongoing pressures in healthcare now. ‘We urgently need to reduce the number of cancellations of appointments, especially last-minute cancellations, and greater action is needed to address widening health inequalities. ‘With industrial action in the NHS being one of the many factors impacting on people’s ability to access timely care, we are also renewing our call for all parties to reach a resolution to mitigate the impact of strikes on patients.’ Cancelled care means carers have to continue to deal with ongoing pain, it affects their mental resilience in some circumstances it can affect their ability to provide care The organisation has called on the NHS to publish more comprehensive data on cancellations and offer better support to people when their cancellations are unavoidable. Commenting on the findings, Helen Walker, chief executive of Carers UK, said: ‘With much of unpaid carers’ time and energy focused on supporting their loved ones who are older, disabled or seriously ill, carers themselves often have little time to address their own health issues. ‘Getting an NHS appointment set up in the first place can be a challenge, so the fact that so many have been affected by cancellations is concerning. ‘Cancelled care means carers have to continue to deal with ongoing pain, it affects their mental resilience in some circumstances it can affect their ability to provide care. It’s vital that the NHS prioritises unpaid carers when addressing the backlog of care appointments.’ An NHS spokesperson said: ‘Obviously industrial action over the last eight months has had a significant impact, with at least 765,000 appointments being rescheduled since they began last year. ‘Hardworking staff are doing all they possibly can to manage this disruption, which includes rescheduling appointments as quickly as possible, with the NHS making progress on the longest waiters including reducing the number of people waiting more than 18 months, down by around a third since April.’