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There are more people waiting for NHS treatment than ever before: recent estimates stand at more than seven million across the UK.
There's also a 'hidden' waiting list of people who haven't come forward for treatment (or weren't able to) during the pandemic. The National Audit Office recently estimated that elective care waiting lists in England alone could reach 12 million by March 2025 if just half of these 'missing' patients return.
The numbers are alarming, and have been making headlines for months. The NHS has released a plan for tackling the backlog, including increased funding, new surgical hubs and diagnostic centres, and greater access for patients to personalised information about waits for treatment, but big changes take time, so what should you do if you or a loved one needs help in the shorter term?
Being stuck on a waiting list can be very difficult emotionally and physically, especially if your condition causes you severe pain or discomfort, but the right support and information can make a difference.
We asked Healthwatch and the Patient's Association for advice if you're waiting for treatment. Find out the questions to ask, when to speak up and what you need to know about going private, if that's an option for you.
Listen to our podcast as we dive deep into your options when you are put on a waiting list for NHS treatment
Getting referred for treatment? What to ask about
If you're being referred for treatment, here's what to ask so you are in the know about next steps:
Ask your consultant about typical waiting times for your condition at the hospital you'll be treated at - they're not guaranteed to know, but should be able to give an estimate.
In England, you can compare waiting times at different hospitals online using NHS England's 'find a hospital' directory.
Ask what you can be doing to get yourself as fit as possible for surgery, and what support there is available to help you do that - this is likely to make your recovery quicker and easier.
Make sure you know who to contact if you haven't heard anything or if your symptoms change.
Ask when the 'clock' stops and starts on your total waiting time - for example, not being able to take up an appointment that's offered can affect this and make you less of a priority (because of the impact on waiting time statistics).
What to do while you're waiting for NHS treatment
It depends on the treatment and your condition, but generally speaking working on your fitness is likely to be helpful for recovery - various programmes are available to help you do this, such as Fitter Better Sooner (from the Royal College of Anaesthetists) and Let's Move with Leon (from Versus Arthritis).
If you're faced with a lengthy wait, and it's feasible for you, you can also choose to go private.
It's a popular choice for those with musculoskeletal issues. New figures from PHIN (the Private Healthcare Information Network) show that self-funded hip replacements increased 167% from July - September 2019 to the same period in 2021, while self-funded knee replacements saw a 127% rise.
Going private tends to be a simpler prospect for one-off surgeries such as these, but there still may be some admin involved in getting a referral and choosing a consultant, and it is of course expensive.
How much will private treatment cost?
Getting a clear picture of what private treatment will cost you isn't always easy.
For example, a knee replacement could cost anywhere from £9,000 to more than £16,000.
There are a few different variables, and a lot depends on whether you're self-paying or using private health insurance.
Private health insurance
This should cover most costs, depending on your policy, but it's important to check, says Matt James, chief executive of the Private Healthcare Information Network (PHIN).
'If your GP has referred you to a specialist for a consultation, contact your insurer to check that they will cover costs for that specialist and hospital.'
He notes that you usually need to do this again if you're referred for further treatment. There are often yearly limits on outpatient services such as diagnostic scans and physiotherapy, so keep asking questions to avoid nasty financial surprises.
The initial outpatient consultation fee for a private appointment is usually between £150 and £300, which you'll be informed of in advance.
If you're offered further tests such as X-rays, or any immediate minor treatment on the day, the costs are unlikely to be included in this initial fee - so you should ask about this.
Your consultant must send you details of the costs for any proposed surgery in advance, and you may want to compare those with other consultants or hospitals.
You can do this on the PHIN website, which should be mentioned on the consultant letters - consultants are legally bound to publish their fee information on this site.
We've gathered self-pay prices for three popular surgical procedures across the UK, and they vary considerably:
Cataract surgery (one eye) cost: £1,720 - £3,565
Hip replacement (total) cost:£9000 - £15,625
Knee replacement (total) cost: £9,433 - £16,795
There are two main ways to self-pay for private care:
Package prices cover all the main costs, including the specialists' surgical fees, which makes it much easier to compare prices. You should still check what is included, especially with follow-up services such as take home medicines, post-operative consultations and physiotherapy.
Fee per service charges mean you'll get separate invoices for each bit of your care, such as the surgeon's fees, and hospital costs from medicines to meals. This isn't necessarily worse value, but it makes the total cost harder to track and predict.
Going private does mean keeping much more on top of your care and the associated costs, but if you want to be seen sooner, it's almost certainly quicker, and you may decide the pay-off is worth it.
Waiting time problems hit poor hardest
Like Covid itself, the treatment backlog isn't affecting people equally.
Some regions are much worse hit than others, and even within regions, your surrounding hospitals might have significantly longer waits than the average.
While the government has announced plans to allow people to travel further afield to cut waits, realistically this is unlikely to be practical or affordable for many.
According to research done by Healthwatch and the King's Fund, people living in areas of social deprivation are statistically more likely to face longer waits.
And of course the option to go private simply isn't there for a lot of people - or it involves going into significant debt.
Does going private affect the NHS?
How opting for private healthcare affects the NHS on a broader scale is complicated.
It's important to make the best choice for you and your health, but the theory that going private alleviates pressure on the NHS by rerouting some of the backlog doesn't quite work in practice: often the consultants end up being the same, so capacity issues may remain.
