Waiting lists
- As of November 2024, the total community services waiting list in England was reported at 1.06 million, reflecting a 1.3% decrease from October.
- The waiting list has consistently remained above 1 million for 10 consecutive months and is now 5.5% higher than in February 2024, when 13 new providers came into the scope of the community health services monthly sitrep. There were 266,600 children and young people waiting for community services in November, a decrease of 3,500 from the previous month.
- The number of adults waiting for community services saw a more marked fall in the latest month, dropping by 9,800 to 789,000.
- 123 NHS trusts and foundation trusts reported waiting list information in November with a combined waiting list of 922,350. 24 trusts account for the top half of the total waiting list. Six trusts report over 20,000 patients waiting for treatment.
FIGURE 6
Community health services total reported waiting list
Waits over 52 weeks
As highlighted by the Darzi report, long waits for community services risk being normalised. That said, long waits have improved for adults for the second month in a row. In the latest month, there were 10,600 adults waiting more than 52 weeks for treatment.
However, there has been an increase in the number of long waits for children and young people (CYP) in the latest month. There were 44,900 CYP waiting for 52 weeks or more, rising by 2% since last month. Since February 2024, when 13 new providers were added to the reporting scope, the number of children and young people waiting over 52 weeks has increased by 63.8%.
Our report Forgotten generation: shaping better services for children and young people examines the challenges children and young people services are facing and highlights the growing concerns for those waiting to access services.
Demand and activity
Referral requests for community services continue to show an upward trend after a rise in demand for community services last month:
- Referrals increased by 8.6% from September to 1.88 million in October – the highest on record. Compared to last year, referrals are up by 16% and compared to five years ago, before the pandemic, referrals are 54% higher. This indicates a sustained and significant rise in demand for community services. Care contact activity levels also reached a record high this month, increasing by 7.9% from September to 9.38 million care contacts in October. Overall care contact activity was 7.7% higher than last year.
The demand for services, along with the activity undertaken by trusts, directly influences waiting times for community services. As one of the government’s three big shifts, moving care from hospitals to community settings will be a priority in the upcoming 10-Year Health Plan.
FIGURE 7
Total referrals received by community services
Urgent community response (UCR) referrals
- As of October 2024, 84% of UCR referrals met the two-hour standard for delivering UCR services, with trusts exceeding the national objective for another month. The target was met across most reporting trusts with 84 out of 91 meeting the 70% target in October. Of these, eight trusts delivered UCR services within the two-hour window to 95% of patients.
Intermediate care - delayed discharges
As of December 2024, virtual ward capacity was 12,700 – remaining at a similar level compared to the previous month. There were 9,600 patients receiving care through virtual wards, meaning the occupancy rate was 75.4%, down from 77% in November. The virtual ward capacity per 100,000 GP registered population aged 16 years and over was 20.1 – in line with last month, but this rate remains below the longer-term ambition of 40 to 50 virtual beds per 100,000 people - as outlined in the Delivery Plan for Recovering Urgent and Emergency Care.
Virtual wards
Virtual wards are a vital part of patient care which allows patients to receive the care they need at home rather than being in hospital. This helps prevent avoidable hospital admissions or supports people to safely leave hospital sooner.
In November 2024, the virtual ward capacity was 12,800 – an increase of 0.7% from the previous month. There were 9,800 patients in a virtual ward meaning the occupancy rate was 77%, down from 78.2% in October 2024.
The virtual ward capacity per 100,000 GP registered population aged 16 years and over was 20.1 – in line with last month, but this rate remains below the longer-term ambition of 40 to 50 virtual beds per 100,000 people - as outlined in the Delivery Plan for Recovering Urgent and Emergency Care.
FIGURE 8
Virtual ward occupancy rate (%)
Community waits and discharge delays must be considered within the broader context of the health and care system, as delays in one part of the sector – whether in hospitals, ambulance services, or community settings – can have a ripple effect on the capacity and efficiency of others. Addressing these challenges requires joined-up working across acute, ambulance, community and mental health settings, as well as partners across domiciliary and social care, to ensure timely discharges and better outcomes for patients.