Safety of patients is being compromised
Over the 14 years of the Conservative government the NHS was chronically underfunded and when Labour came to power in July 2024, Wes Streeting, Secretary of State for Health and Social Care, declared the NHS 'broken'. The years of underfunding had created an NHS that threatened the safety of patients due to lack of funding and staff.
In late 2016, The NHS Support Federation and the TUC published “Patient Safety - A Warning From All Sides” an overview of reports and articles published by the Royal Colleges, such as the RCN and RCM, unions, charities and think-tanks spanning all areas of the NHS - nurses, midwives, hospital doctors, GPs, and mental health professionals.
Since 2016, more and more evidence has been presented by those same organisations and others that little has changed. Patient safety continued to be compromised and the NHS continues to be stretched almost to breaking point by lack of funds and lack of staff.
Consensus on what leads to safety issues
Patient safety in the NHS has been compromised by over a decade of underfunding that has led to a workforce crisis (see Staffing), infrastructure that is not fit for purpose (see Crumbling infrastructure), delays to treatment (see Delays to treatment), rationing (see Waiting lists and rationing), and lack of sufficient training for staff.
The 2019 report, “Patient Safety Learning: A Blueprint for Action”, stated that despite 20 years of effort, avoidable unsafe care still leads to tens of thousands of patients suffering every year.
The July 2022 Parliamentary Committee report - Workforce: recruitment, training and retention in health and social care - included evidence from over 150 organisations, including all medical Royal Colleges, charities, healthcare analysts, such as The King’s Fund, The Health Foundation, and The Nuffield Trust, independent researchers at universities, councils, and unions representing staff in the NHS. The overall conclusion - staff and patient safety was at risk due to the ongoing workforce crisis.
Since 2016 and 2022, change has been slow and the safety of patients is still an issue, in particular in mental health services and ambulance services.
Ambulance delays and A&E waits increase deaths
There is considerable evidence that waiting a long time for an ambulance and to be seen in emergency departments is costing lives.
In January 2025, the Office for National Statistics (ONS) published a study that found that for patients who spent 12 hours or more in the department, the risk of post-discharge death was 2.1 times higher than those who spent two hours or less.
For those who spent nine hours in A&E, mortality was 1.9 times higher and 1.6 times for those who spent six hours, and 1.1 times for three hour stays.
The ONS also found the biggest differences in risk of post discharge death after 12 hours in A&E, compared with two hour stays, were among younger people (for patients aged 20 years, for example, the risk of death at 12 hours was 4.6 times higher than at two hours) those in London (2.7 times higher), those who attended A&E with eye problems (7.9 times higher), and those who were not admitted to hospital (2.8 times higher).
In December 2024, the government abandoned a pledge that the NHS would hit the four A&E targets, in favour of focussing the NHS on recovering its elective care performance. NHS England recently advised trusts to focus on keeping patients attending emergency care “safe” while they waited.
In November 2023, HSJ conducted an analysis of the data on long waits in A&E departments and concluded that they have caused around 30,000 ‘excess deaths’ in 2022-23, up from 22,175 in 2021-22, and 9,783 related deaths in 2020-21.
The data suggests the rate of excess deaths from 2022-23 continued into 2023-24.
The analysis used a methodology in a peer-reviewed study published in the Emergency Medicine Journal, which found delays to hospital admission for patients of more than five hours from time of arrival at A&E were associated with an increase in all-cause mortality within 30 days.
A Guardian investigation published in November 2023 managed to get NHS England to release data on the harm a long wait for an ambulance or surgery can have.
Analysis of the data concluded that almost 8,000 people were harmed and 112 died in 2022 as a direct result of enduring long waits for an ambulance or surgery.
They show that patient deaths arising directly from care delays rose more than fivefold from 21 in 2019 to 112 in 2022. The number of people who came to “severe harm” also jumped from 96 to 152 during that period.
In November 2022 a report in the Sunday Times covered a number of stories of people dying due to long waits for ambulances. The coroner for Cornwall Andrew Cox wrote to the then Health secretary Steve Barclay, to tell him he must act to prevent more deaths. Mr Cox, who investigated deaths in his area discovered what was driving long waits for ambulances in his area - the lack of care home beds and investment in social care.
A paper published in the BMJ in April 2021 found that the risk of death in the month following A&E attendance was 16% higher for those who waited over 12 hours than those seen within four. Based on this paper and additional data, John Burn-Murdoch's analysis in the FT in August 2022 concluded that the collapse of emergency healthcare in England may be costing 500 lives every week due to excess waiting times. For June 2022, Burn-Murdoch's analysis found 2000 excess deaths associated with waiting so long for urgent care or admission.
Nurse shortages linked to patient safety
The key issues for nurses in the NHS continue to be recruitment and retention. Latest statistics from the Royal College of Nursing reveal there are over 27,000 nursing vacancies across health and social care settings in England. More on staffing shortages can be found here. There is now considerable evidence that lack of nursing staff adversely affects patient safety.
Not enough nurses to provide safe patient care
A Unison survey released in April 2025 found that there were not enough nursing staff on duty in hospitals to ensure patients are protected from harm such as falls, medication errors or other risks.
In the survey healthcare workers who do clinical jobs said not enough staff were present to deliver safe care on two thirds (69%) of shifts. The proportion has risen from 63% when the research was previously carried out in 2023.
Staff reported the highest proportion of safety concerns after shifts on maternity wards (81%), in rehabilitation units helping people recover from injury, illness or disability (81%), or those looking after the elderly (82%).
The findings are based on more than 1,400 shifts completed at over 40 hospital sites by clinical staff in England, Wales and Northern Ireland and give a comprehensive snapshot of the situation, says UNISON.
A ‘red flag’ event, involving a serious risk to safety, occurred on more than half (56%) of all shifts. But these were significantly more common where the shifts were not thought to be sufficiently staffed (67%) than those that were (16%).
A delay greater than 30-minutes in providing pain relief was reported on more than half (54%) of ‘unsafe’ shifts, compared with 12% where enough staff were present.
UNISON also analysed NHS board papers and staffing policies in the hospitals where surveys were conducted. They found that only one in twelve of the hospitals sampled in England were fully implementing safety measures brought in after the Mid Staffordshire NHS Foundation Trust scandal to prevent such staff failings from occurring again.
Research shows nurse shortages linked to patient safety
A study published in BMJ Quality & Safety in April 2025 by researchers at Southampton University shows that understaffing by registered nurses is associated with "higher risks of patients dying, being readmitted and longer stays in hospital." Responding to the paper, Lynn Woolsey, RCN's Chief Nursing Officer, said:
“This report is yet more evidence of the clear link between nurse shortages and higher patient mortality. As the highly-skilled, 24/7 presence in hospitals nursing staff should be a priority for investment but the reality is we are undervalued and short of tens of thousands."
"As student recruitment collapses and the numbers quitting nursing rises, new funding to boost recruitment and retention couldn’t be more urgent. This must include a fair pay award this year that nursing staff can get behind. Any further delay will only deepen the workforce crisis and harm patient care.”
In November 2024, a study from the University of Surrey shows "a clear association between high turnover rates of nurses and doctors in NHS hospitals and a troubling rise in patient mortality rates."
The researchers found that a one standard deviation increase in nurse turnover is associated with 35 additional deaths per 100,000 hospital admissions within 30 days. For senior doctors, a similar increase in the turnover rates correlates with an additional 14 deaths per 100,000 admissions. With an average of 8.2 million hospital admissions occurring annually, the turnover rates of hospital nurses and senior doctors could translate to nearly 335 additional deaths each month across the NHS.
The authors note "Our findings underscore the vital role that stable staffing plays in ensuring patient safety. High turnover rates are not simply an administrative issue; they have real, life-or-death implications for patients. It's time for healthcare leaders to focus on retention strategies that prioritise workforce stability."
The issue of patient safety due to lack of nurses has been highlighted time and time again over the past decade.
The RCN have previously called for urgent action on the crisis in nurse recruitment in September 2017. The RCN’s report “Safe and Effective Staffing: Nursing Against the Odds”, based on the experiences of more than 30,000 nurses, had found “a perturbing picture of staff stretched to the limit and compromised patient care.” Once again, in their 2019 report the RCN noted that if there is understaffing care is more likely to be compromised, of poor quality, or left undone.
Unsafe corridor care highlighted in RCN report
A report in November 2024 - Corridor Care: Unsafe, Undignified, Unacceptable - from the RCN highlighted the widespread use of corridor care. An RCN survey of almost 11,000 frontline nursing staff across the UK found that when asked about recent shifts, more than one in three (37%) nursing staff working in typical hospital settings report delivering care in an inappropriate area, such as a corridor.
Of those being forced to deliver care in inappropriate settings, over half (53%) say it left them without access to life-saving equipment including oxygen and suction. Almost seven in ten (67%) said the care they delivered in public compromised patient privacy and dignity.
The RCN report called for the government to address the workforce crisis, including improved pay.
Safety-critical nurse-to-patient ratios called for once again
In July 2024, the RCN released the latest data from its Last Shift Survey which shows the urgent need for investment in the nursing workforce and for safety-critical nurse-to-patient ratios to be enshrined in law. New analysis of more than 11,000 members reveals just a third of shifts had enough registered nurses.
Chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. The survey found that 1 in 3 hospital shifts were missing at least a quarter of the registered nurses they needed, while in the community almost 4 in 10 shifts were missing up to half of the planned number of registered nurses.
In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. In outpatients, caseloads of more than 51 patients were consistently reported.
Across all settings, 80% of respondents said there aren't sufficient nurses to meet the needs of patients safely.
Despite recommendations from the Francis report in 2013, that the ratio between staff and patient was of fundamental importance to safety and quality of care, the Conservative government refused to produce adequate guidance in this area.
Some guidance was published in 2014/15, on staffing in acute wards, but soon after this NICE was told to halt the work on safe staffing levels in A&E and urgent care. NHS Improvement took over and in November 2017, its guidance for A&E and urgent care set no staffing ratios and states there is “no evidence base to support a specific ratio”. This is in contrast to the guidance produced by NICE by experts working in A&E leaked to the press in January 2016, which did set minimum nurse to patient ratios and staffing levels for areas of A&E departments.
In 2023, a review of the literature was published by the RCN - Impact of Staffing Levels on Safe and Effective Patient Care, which highlighted that the evidence from other countries was that having minimum nurse to patient ratio policies help improve nurse staffing levels and improve patient outcomes. The evidence demonstrates that minimum staffing average levels at a ward or setting level are easier to implement, and evidence good outcomes for both patients and employers.
More on safe staffing levels and plans can be found here.
Midwives - safety of mothers and babies compromised
There is a serious issue in the NHS with the shortage of midwives that is affecting the safety of mothers and babies. The predominant issue influencing safety is a lack of staff, with staff feeling under severe pressure with excessive workloads. Lack of staff also leads to the closure of maternity units.
In April 2025, the Royal College of Midwives described the Government and NHS England’s decision to slash crucial ringfenced maternity service funding as ‘utterly shocking’ and will "rip the heart out of any moves to improve maternity safety."
The decision will see national Service Development Funding (SDF) for maternity services drop from £95m in 2024-25 to just £2m in 2025-26.
Commenting, the RCM’s Chief Executive, Gill Walton said:
“The Government has taken a wrecking ball to the work that’s being done up and down the country to improve maternity safety, something which is desperately needed. What they’ve done is an insult to the women and families who have received care that has fallen short, the same women and families who have campaigned so hard to make maternity safety a priority for successive governments. They are just as insulting to the midwives and wider maternity teams who are working tirelessly to drive safety improvements across maternity services in England. Furthermore, these cuts go against the Government’s very own commitment to reduce inequalities and poor outcomes for Black, Asian and minority ethnic women.”
The Government’s decision will see the funding made available following Donna Ockenden’s report into maternity failings at Shrewsbury & Telford Hospitals Trust disappear. This funding would have allowed for extra posts in services to support enhanced care for complex pregnancies, multiple births or bereavement care and support. All those roles will now be at risk says the RCM.
Maternity services have been hit by several safety scandals in recent years. One of the most notable was that of Shrewsbury and Telford hospitals. A review, led by Donna Ockenden, found patterns of failures led to deaths and harm to mothers and babies between 2000 and 2019. The Ockenden review, which was published in 2020, found 1,862 serious incidents including hundreds of baby deaths and a high number of maternal deaths. A number of recommendations emerged from the report including greater oversight on maternity care by senior doctors, ring-fenced funding for maternity training and development of regional specialists in maternal medicine.
In May 2022, Donna Ockenden was appointed to begin a review of the quality and safety of maternity services at Nottingham University Hospitals NHS Trust (NUH) and concerns of local families. The latest update of this review was in February 2025.
The safety issues associated with lack of staff in maternity has been highlighted time and time again.
Parliamentary reports says thousands of staff needed
In July 2021, the House of Commons Health and Social Care Committee report - The Safety of Maternity Services in England - made a number of recommendations to improve safety in maternity services. It recommended that NHSE needed an additional 2,000 midwives and 500 obstetricians to operate at a level that the staffing tool Birthrate Plus considered safe. Plus the budget for maternity services should be increased by £200–350m per year.
Despite the committee recommendations, little happened, instead the situation deteriorated with midwife numbers falling month on month, worsened further by pandemic related staff sickness and absences. Data for April 2022 showed the number of midwives has dropped by 600 compared to April 2021.
An RCM State of Maternity Services report released in July 2023 noted that the impact of staffing shortages on women is ‘stark and sobering’ and highlights historical failures to invest appropriately in maternity services.
According to the report’s findings, if the number of NHS midwives in England had risen at the same pace as the overall health service workforce since the last general election, there would be no midwife shortage. Indeed, there would be 3,100 more midwives in the NHS, rather than having a shortfall of 2,500 full-time midwives.
RCM survey shows serious concerns
An RCM survey released in June 2023 found that midwives give 100,000 hours of free labour to the NHS per week to ensure safe care for women. As a result, the mental and physical health of midwifery staff is being compromised by excessive workloads, with staff feeling burnt out and exhausted at the end of shifts.
The survey "paints a deeply worrying picture of workplace conditions and the impact on safety in England’s maternity services" said the RCM.
Dr Suzanne Tyler, Executive Director, Trade Union, at the RCM, said: “Report after report have made a direct connection between staffing levels and safety, yet the midwife shortage is worsening."
The survey also showed that maternity services are consistently understaffed which is hitting safe staffing levels. Almost nine out of 10 (87%) respondents said their maternity units were not staffed safely in the week of the survey.
Hospital doctors - too few leads to safety concerns
Doctor retention critical to patient safety
As already discussed, the University of Surrey's work published in the BMJ in November 2024 showed a clear association between high turnover rates of nurses and doctors in NHS hospitals and a troubling rise in patient mortality rates. The study analysed nearly a decade of data from 148 NHS acute hospitals in England.
The data showed that for senior doctors, a similar increase in the turnover rates correlates with an additional 14 deaths per 100,000 admissions.
The findings suggest that as turnover rates increase, the quality of care diminishes, leading to higher mortality risks for patients, particularly those admitted for emergency care. Notably, high turnover rates among senior doctors are linked to increased mortality in patients suffering from infectious diseases and mental health disorders.
The research suggests that addressing the root causes of turnover—such as job satisfaction, working conditions, and staff engagement—is essential for improving patient outcomes.
Job vacancies go unfilled and unsafe rotas
Recent research by the Nuffield Trust submitted to the Health and Social Care Parliamentary committee in 2022 suggests that the NHS in England could be short of 12,000 hospital doctors.
Previous research by the Nuffield Trust found that two in five consultants and nearly two-thirds of senior trainee doctors said there were daily or weekly gaps in hospital cover in 2019. Gaps in rotas can mean there are not sufficient senior medical staff to ensure quality and safety of training. This can result in junior doctors withdrawing from hospitals, exacerbating staffing issues.
The latest Royal College of Physicians (RCP) census found a record number of physician jobs unfilled; more than half (52%) of advertised consultant physician posts in England and Wales went unfilled in 2021. This was up from 43% before the pandemic and 48% in 2020 and the highest rate since records began in 2008. Of the 52%, nearly three quarters (74%) were unfilled due to a lack of any applicants at all.
Waiting times in A&E lead to unsafe care
In A&E waiting a long time to be seen is costing lives. A paper published in the BMJ in April 2021 found that the risk of death in the month following A&E attendance was 16% higher for those who waited over 12 hours than those seen within four. Based on this paper and additional data, John Burn-Murdoch's analysis in the FT in August 2022 concluded that the collapse of emergency healthcare in England may be costing 500 lives every week due to excess waiting times. For June 2022, Burn-Murdoch's analysis found 2000 excess deaths associated with waiting so long for urgent care or admission.
The official figures for July 2022 show almost 30,000 patients were kept waiting over 12 hours in A&E following a decision to admit. The delay was largely due to lack of staff, which means beds can not be made available. This has been worsened by delays in discharging people who no longer need hospital care due to the lack of social care and community health services.
Time-critical cancer care still not possible
In cancer treatment, time is critical if a patient is going to survive - time to get a definite diagnosis and time to treatment - so targets were set to make sure patients got the best chance possible of surviving the disease.
After many years of worsening figures for time-dependent cancer care, things have improved over the past couple of years, but there is still considerable need for improvement.
The operational standard, a target set by NHS England in August 2023, is that at least 75% of patients either receive a cancer diagnosis or have it ruled out within four weeks (28 days) of an urgent GP referral.
In February 2024, 78% of patients waited less than four weeks to receive a cancer diagnosis, making it the first time since its introduction in October 2021 that the 75% target has been met. The target was met the following month as well, but in April 2024 the target was missed by 1.5%. Since May 2024, the target of 75% has been met each month apart from September 2024. In November 2024, 77% of patients either received a cancer diagnosis or had it ruled out within four weeks (28 days) of an urgent GP referral.
Performance in March 2025 was up to 79% of people who had their first treatment for cancer following an urgent GP referral waited less than two months.
Another operational standard - two month (62 days) wait from an urgent suspected cancer or breast symptomatic referral, or urgent screenings referral, or consultant upgrade to a first definitive treatment for cancer - was set at 85% in August 2023. This has never been met, but hovered around 65% in 2022/23 and 2023/24, rising to 68% in 2024/25. The figure for March 2025 was 71.4%, the highest since the target was put in place.
Previous figures were much worse. In August 2022, figures leaked to the HSJ and shared with BBC’s Newsnight team showed almost a third of a million people (327,000) were on cancer waiting lists in England, almost 40,000 of them waiting for treatment to begin more than 62 days after a GP referral. Worse still numbers waiting over 104 days had more than doubled in a year, to more than 10,000.
Deaths due to delays to heart valve treatment
The Guardian reported in May 2025 on research by the medical group Valve for Life that found that hundreds of patients with aortic stenosis (AS), a serious but symptomless disease that weakens the heart’s aortic valve, are dying every year while stuck on an NHS waiting list .
About 300,000 people across the UK have aortic stenosis (AS), and although AS is often fatal, patients survive and regain a normal life if it is detected and treated early. But the research found that more than 400 people a year with AS die because they cannot get access fast enough on the NHS to a life-saving non-surgical procedure called transcatheter aortic valve implantation (Tavi).
The research has come from a survey of Tavi waiting times at the 35 specialist centres across the UK that provide the procedure. The research found that the average waiting time for the procedure across the UK is 142 days, even though those with severe AS have a 50% risk of dying. Furthermore, white patients are more likely to undergo Tavi than those from minority ethnic communities.
In an article for the website Cardiology News, Dr Jon Byrne, a cardiologist at King’s College hospital in London, wrote: “These findings expose a growing crisis in access to Tavi across the UK. Despite the dedication and expertise of clinicians delivering exceptional care under increasing pressure, system inefficiencies, health inequalities and capacity constraints continue to put patients at risk."
Mental health - many issues mean vulnerable patients are not safe
Mental health services have several issues related to patient safety - lack of staff, waiting times, crumbling infrastructure, and a lack of coordination between children's services and adult services and social services.
The issue of safety in mental health services is a long-standing one. In April 2025, the first key evidence sessions began in the Lampard inquiry, the first public inquiry into mental health deaths. Led by Baroness Lampard it will examine more than 2,000 deaths at NHS inpatient units in Essex between 2000 and 2023.
The inquiry, however, is facing difficulties obtaining records from organisations and has had to issue a number of Section 21 legal notices to NHS organisations to force them to submit evidence. The inquiry has already highlighted issues surrounding retaining reports written by the coroner, that have the aim of preventing further deaths (prevention of future deaths/PFD) and that they "did not appear to have been a priority for some providers".
Other issues include multiple failures in the care, management and treatment of the patient that amounted to neglect. Furthermore, the reduction in inpatient units (from 27 to 16) over the decade was an issue as the reduction was combined with a significant increase in the numbers needing help after 2023.
Lack of staff = safety issues
The workforce crisis within the whole NHS is particularly acute within the mental health services sector. More details can be found in Staff Shortages. The safety of patients with mental health conditions is being compromised both by a lack of staff and a lack of bed capacity.
A lack of staff, which translates into a lack of beds in inpatient units, compromises patient safety because:
- Long waiting times for appointments means that a patient’s health deteriorates before they can be treated, leading to longer recovery times or worse outcomes for the patient, with suicide whilst waiting for care a major issue;
- Inpatient units with too few staff struggle to monitor patients adequately, which can lead to patients coming to harm;
- Patients have to be sent to inpatient units far away from home, which can negatively impact on recovery.
Vulnerable patients not monitored
An independent report published by the Health Services Safety Investigations Body (HSSIB) in December 2024 found that young people who have only just turned 18, are being discharged from mental health hospitals to bed and breakfast hostels, caravans on holiday sites, or even being made homeless.
There are patient safety issues due to the following:
- Young people being discharged to adult services simply because they have reached ‘transition age’ overnight and not because their mental health care needs have changed.
- Young people being discharged from children’s wards often not able to access adult inpatient services because the thresholds for support are different between services, leaving them without care or with inadequate care.
- Young people being discharged from mental health hospitals to bed and breakfast hostels, holiday caravans or even made homeless due to a lack of suitable mental health facilities.
- Services at a local level are not always well integrated and this contributes to issues with transitions.
Dr Sarah Hughes, Chief Executive of Mind, said:
“Discharging a vulnerable 18-year-old who may lack the life skills needed to live independently, to a holiday caravan or bed & breakfast hostel, or even making them homeless, when only a day before they were eligible to receive 24/7 care, is unforgivable. What’s needed are flexible transitions and people’s situations to be treated on a case-by-case basis, which can deliver safer and more successful outcomes.
In August 2022 NHS data was released that showed that vulnerable patients released from inpatient care were not being properly monitored. The risk of suicide is highest on the second and third days after leaving a mental health unit, but 37,999 follow-up appointments with patients were not made within this timeframe in England between April 2020 and May 2022. A target of at least 80% of people being followed up within this timeframe was introduced in the year 2019-20, but this has never been achieved. The problem is lack of staff, including trained specialists, and funding, according to The Royal College of Psychiatrists, which called for more of both.
Out-of-area placements affect patient safety
In November 2024, the Health Services Safety Investigations Body (HSSIB) released a report on ‘inappropriate’ out of area placements (OAPs) - where a lack of an available bed in someone's local area leads them to be placed in a mental health inpatient setting that is a long way from their home and support network. The Conservative government had set a target to eliminate inappropriate out of area placements by 2021.
Among the report’s key findings were:
- Harm, including psychological and physical distress and anxiety, and deaths by suicide were caused by inappropriate OAPs
- OAPs can lengthen people’s stay in hospital and contribute to harm to patients
- Patients, families and carers rarely want an OAP and their choice and opinions are not always taken into consideration when decisions about sending someone to an OAP are made
There has been plenty of evidence over recent years that the safety and recovery of mental health patients is compromised by sending patients miles away from home for treatment, including reports in August and September 2018, looking at child/adolescent and adult mental health patients. By 2022, things had not improved and OAPs are still happening in 2025.
The NHS does not have the capacity to treat all the mental health patients, particularly those needing inpatient care, and is heavily reliant on the private sector. The leading companies, including The Priory, Cygnet Healthcare and Elysium Healthcare, provide hundreds of beds across the country. However, the past few years has seen many private hospital units closed down or rated 'requires improvement' by the CQC due to safety concerns. Details of many of these issues can be found on our www.nhsforsale.info website.
Waiting lists rocketing
In late 2021, the official waiting list for mental health services stood at 1.6 million people and NHS Providers estimated that there are around eight million people in England that are denied access to mental health services because they do not have severe enough symptoms to get put onto a waiting list.
The eight million figure is based on the known prevalence of mental health conditions and the thresholds dictating who gets access to treatment; NHS England considers it an accurate figure for the number of people who are missing out on care because services are not adequate. So the true figure of people waiting for mental health services is around 10 million.
This is 10 million people whose conditions are potentially getting worse as they wait and as a result may harm themselves.
Long waiting lists increases suicide risk
In July 2022 the charity YoungMinds reported that thousands of young people are being left waiting so long for mental health support or treatment that they have attempted to take their own lives. Almost 14,000 young people aged under 25 completed a survey for the charity.
More than one in four young people (26%) said they had tried to take their own life as a result of having to wait for mental health support. More than four in ten (44%) waited more than a month for mental health support after seeking it and almost one in 10 (9%) of young people were turned away. More than half of young people (58%) said their mental health got worse while they were waiting for support.
The figures come as latest NHS data shows 66,389 young people aged 19 and under were referred to Child and Adolescent Mental Health Services (CAMHS) in April 2022, a 109% rise compared to the same month pre-pandemic.
In February 2020 A survey published by the Parliamentary and Health Service Ombudsman found that one in five people did not feel safe while in the care of the NHS mental health service that treated them. Over half of people with mental health problems in England also said they experienced delays to their treatment, while four in ten (42%) said that they waited too long to be diagnosed.
Deaths of patients due to lack of services
In March 2018, the Guardian reported that coroners had identified 45 cases in the last six years where a lack of beds, staff and specialist services affected the care of dozens of mental health patients who later died. The Guardian's own investigation found that at least 271 highly vulnerable mental health patients have died over the last six years after failings in NHS care.
GPs - surgery closures and unmanageable workload
There are widespread problems with both the training and recruitment of new GPs and the retention of current GPs. The lack of GPs leads to patients not seeing patients as soon as they would like, as well as large and often unmanageable workloads for the GPs.
In 2015 the Government promised 5,000 extra GPs by 2020, then extended to 2021. In 2016 and 2017, the pledge was repeated. In the 2019 general election campaign, Boris Johnson announced a new commitment to increase the number of GPs in England by 6,000 by 2024. However, Sajid Javid, the then health secretary, admitted in November 2021 that this pledge was unlikely to be met because so many family doctors were retiring early.
In reality, the number of GPs in England has fallen every year since 2015. In March 2025 there were 15,599 FTE GP partners compared to 16,143 in March 2024: a total loss of 544 FTE GP partners in the last year alone. On a headcount basis, there was a loss of 580 GP partners in the last year.
Patient safety is at risk if GPs are overworked or if patients can not get to see a GP in a timely manner.
The number of practices has fallen, either entering mergers or closing permanently. As of March 2025, 1,404 practices have closed since 2015. Factors causing this can include partner retirements, the inability to recruit staff or GP partners.
Whilst the GP workforce has been declining, the number of patients continues to increase, therefore increasing the workload of each GP. In March 2025 another record-high of 63.77 million patients were registered with GP practices in England, an increase of 6.86 million since 2015. As a result, the average number of patients each full-time equivalent GP is responsible for now stands at 2,255. This is an increase of 317 patients per GP (16.4%) since 2015.
An investigation by Pulse reported in May 2018 found that since 2013 over a million patients have had to move surgeries due to practice closures. In this time, nearly 450 GP surgeries have closed. Closures have been due to problems with recruitment and funding, as some practices had huge cuts due to Government reforms. Patients often have to travel further to a new surgery and lose continuity of care.
Lack of children's services leading to long-term damage
Delays to the treatment of children can cause serious and long-term damage to their health, according to a report by the Royal College of Paediatrics and Child Health (RCPCH) published in September 2024.
Children are suffering chronic pain, asthma flare-ups, weight loss and developmental problems because of long delays for NHS care. Some under-18s are finding it so hard to obtain prompt treatment for their diabetes or epilepsy that they are forced to turn to A&E for care because their health has deteriorated so badly.
In the report a paediatrician specialising in neurodevelopmental problems said children who joined the list had to wait six years for their first appointment because the service was unable to meet demand. Another said the average waiting time for an initial consultation was three years and five months.
The anxiety and challenges caused by the delays can be so difficult for children and families to deal with that some parents have even split up as a result of that pressure, because they have reached “breaking point”, the college said. In addition, some families are being forced to pay for private care, in order to circumvent NHS waiting lists.
The RCPCH said its survey of 195 paediatricians working in the four home nations showed that NHS officials had to put more resources into under-18s care.
It also found that some children are:
- Putting on a lot of weight because of long delays in getting an initial blood test for hypothyroidism and then seeing a specialist in hormone-related conditions before starting treatment.
- Spending years in poverty because their family has not been able to claim child disability welfare benefits while they wait for a paediatrician to diagnose their conditions.
- Suffering huge emotional damage because of the anxiety waiting for appointments, tests and treatment for what can feel like a significant portion of their life.
Dr Ronny Cheung, the college’s officer for health services, said:
“The impacts of long waits are as devastating as they are far-reaching: children and their families denied child disability payments until seen by a paediatrician; mild symptoms progressing into much more complicated conditions and a reduced quality of life, school exclusions and wider family stress. These are impacts that will have lifelong consequences and, tragically, are repeated hundreds of thousands of times across the UK.”
Some children with spinal deformities end up with heart and breathing problems because they have to wait so long to have surgery, or the operation becomes riskier, Cheung added.
The physical and mental effects of care not being received for prolonged periods can also lead to children missing a lot of school or, in some cases, not being able to attend at all. That can in turn mean they suffer a loss of time with friends, social isolation and anxiety.