Over the last few years, following pressure from the sector and stakeholders, NHS England started collecting and publishing more data on the community sector. For instance, data on the total waiting list size is only available from 2022. This data now provides us with a national picture.
Waiting lists
As highlighted in the Lord Darzi report, the community health services waiting list have surged, and the long waits are being normalised. After a fall in June, the community health services waiting list now stands at 1.10 million in July 2024. This is an increase of 2.8% since the previous month and the highest figure on record. The waiting list has now remained over 1 million for six consecutive months, since February 2024 when 13 new providers came into scope of the community health services monthly sitrep.
The number of people waiting for adult and children and young people community health services have both increased in the latest month. As of July 2024, there are 807,000 adults and 290,200 children and young people on community services waiting lists. This is an increase of 3% and 2.4%, respectively compared to the previous month.
In the latest month, 11,100 adults were waiting for more than 52 weeks for treatment a reduction of 3.3% since last month. However, the number of children and young people waiting over 52 weeks has increased by 4.7% to 42,600 since last month and is almost double the number of children waiting compared to February 2024 when 13 new providers were added to the reporting scope.
It is evident from the data that children and young people are still suffering the longest waits for community services, accounting for 79% of those waiting for over 52 weeks. Our report Forgotten generation: shaping better services for children and young people examined the current challenges children and young people services are facing and highlights the growing concerns for children and young people waiting to access services.
123 NHS trusts and foundation trusts reported waiting list information in July. The combined total of their waiting list totalled 949,944. As seen in the previous month, six trusts reported over 20,000 patients waiting for a community health service.
Community health services total reported waiting list
The Lord Darzi report highlights community services as one of the main areas where patients waiting a long time for care from services is being normalised. Work is already underway to shift care away from hospitals into the community but, without the right resources available, patients are having to wait even longer which highlights the need for greater attention and investment in these areas.
Demand and activity
Demand for community services appears to have fallen in the latest month as there were a total of 1.61 million referral requests in June 2024, relating to 1.12 million persons needing care. Referrals are down by 7% compared to the previous month, when figures were at a record high (1.73 million in May 2024). Care contact activity has also fallen as the number of care contacts that took place in June 2024 fell by 5.3%, since last month, to 8.51 million (see figure 5 below). This is it a similar level compared to the same time last year (0.2% fewer care contacts).
Total care contacts by community services
As of June 2024, 85% of urgent community response (UCR) referrals met the two-hour standard for delivering UCR services. This meets the national objective set out in the 2023/24 priorities and operational planning guidance which states trusts should consistently meet or exceed the 70% two-hour urgent community response (UCR) standard. The target was met across most reporting trusts with 83 out of 93 reporting trusts meeting the 70% target in June. Of these, 30 trusts delivered UCR services within the two-hour window to 90% of patients, up from 26 trusts in May 2024.
Percentage of two-hour UCR referrals achieving the two-hour standard
Intermediate care - delayed discharges
The community discharge situation report has been discontinued and replaced by the intermediate care data collection. Intermediate care refers to the short-term interventions that aim to maximise people's independence and quality of life following or during a period of illness. This usually involves rehabilitation, reablement and recovery support and can be provided in a person's home or in a community bedded setting.
The intermediate care data collection provides comparable data with the community discharge sitrep for discharge delays: the number of patients not discharged by the end of the day despite no longer meeting criteria to reside. The latest data shows that on average in August, 88% of patients who no longer met the requirements to remain in intermediate care services remained in hospital. This is up from 87.1% in July but remains broadly consistent since the data was first recorded in October 2022.
As outlined in our five shared commitments for delivering the next generation NHS it is important patients are discharged into the right care at the right time. Lord Darzi's report highlighted that too many people are ending up in hospital due to the lack of investment into community services. More investment into community services will help reduce discharge delays, improve patient flow and ensure people receive the right care, in the right place at the right time.
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 August 2024, the virtual ward capacity was 12,366 – similar to the previous month (12,365).
There was a total of 8,403 patients in a virtual ward meaning the occupancy rate was 68.0%, down from 73.9% in July 2024. The virtual ward capacity per 100,000 GP registered population aged 16 years and over was 19.6 – same rate as the previous month and still a way to go to reach 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.