The amount of patients waiting more than 18 weeks for planned surgery has hit a ten year high.

Patients waiting for planned operations are paying the price for seeing the NHS through one of the worst winters in recent memory, warns the Royal College of Nursing, as waiting lists hit half a million.

Waiting lists are on the rise following the decision at the beginning of January to delay tens of thousands of operations as the health and social care system struggled to cope with the pressures of a colder than average winter.

According to the latest figures, in April this year 500,068 people had been waiting more than 18 weeks for planned operations, an increase of more than 30 per cent (382,000) on the same time last year.

This is the highest figure since August 2008 when the number of people waiting more than 18 weeks stood at 520,564.

'A worrying upward trend'.

The April figure marks a worrying upward trend since January 2018, when the waiting list stood at 392,000.

The latest April figures also show the number of patients waiting more than a year has increased 83.8 per cent since the same period last year, from 1,568 to 2,882. This represents a 637 per cent increase from the same period in 2013.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: “Cancelling non-urgent care may have helped the NHS fight though one of the worst winters in recent memory, but patients in need of elective surgery should not have to pay the price for chronic staff shortages and years of underfunding.

“Half a million people have waited more than 18 weeks for planned care, the highest figure in ten years. And the number waiting more than a year is approaching 3,000. That is truly shameful. For these people, the Prime Minister’s promise of more NHS funding cannot come soon enough.

“But more funding is only half the battle. Addressing the 40,000 nurse vacancies in England alone is not just a question of money, but requires long term workforce planning and a determined focus on improving recruitment and retention.”

NHS trusts in England have reported a combined financial deficit of nearly twice the amount planned.

The figures, released by NHS Improvement, showed a system under systematic strain and an NHS deficit of £960m in the last financial year - nearly double what the organisation had planned for.

NHS Improvement pointed out that 156 of the 234 trusts finished the year either reaching or exceeding their financial targets and said that acute hospitals were responsible for the overspend due to an increased patient demand. It added that other NHS organisations including ambulance services and mental health trusts had collectively underspent.

During January, February and March alone, there were 1.1 million people who attended A&E who needed to be admitted for treatment – 70,000 more than the same period last year.

Heavily reliance on temporary workers.

The Royal College of Nursing has said that the chronic staffing shortage is partly to blame for the overspend with high vacancy rates and a heavy reliance on expensive temporary workers.

Offical figures show the sector is faced with 92,694 staffing vacancies - including 35,794 nursing vacancies and 9,982 medical vacancies.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: “These figures reveal both sides of the same coin – a cash-starved NHS forced to run without enough staff to treat people safely. For as long as hospitals remain £1 billion in the red, patients will pay a heavy price.

“The number of nurses missing from England’s NHS remains stubbornly high – hospitals cannot afford to recruit and inadequate numbers are being trained too.

“Theresa May and Philip Hammond cannot allow this financial knife-edge to continue. Whether the Chancellor announces the extra funding in time for the NHS anniversary this summer or waits until the Autumn Budget, it must be both substantial and genuinely new money. It would not be enough just to wipe these deficits – health and care budgets must be boosted to reflect genuine demand. Anything less exposes patients to unacceptable risks and leaves care increasingly unsafe.”

'Incredible resilience'

Ian Dalton, Chief executive of NHS Improvement, said: "Despite epic challenges, NHS staff up and down the country displayed incredible resilience and saw more patients than ever before within four hours.

"More than two-thirds of providers ended the year on budget or better than planned. Given rising demand and record vacancies, this is an important achievement."

Chris Hopson, Chief executive of NHS Providers claims a 5% annual increase in NHS funding is needed to maintain the same levels of care seen in Europe.

The Welsh Government has announced it will ban smoking outside hospitals from next summer.

The Welsh government has announced plans to extend the smoking ban to hospital grounds, school grounds and playgrounds by summer 2019  - with fines for smokers breaking the rules.

Officials claim that strengthening the laws around smoking in public will help protect non-smokers from second-hand smoke and "de-normalise" smoking for kids and young people.

Health Secretary, Vaughan Gething, said: "I am proud that Wales continues to be at the forefront of UK action to reduce smoking and prevent young people from taking it up in the first place.

"We have seen significant changes to the attitudes to smoking since 2007. Back then we received some resistance to change, but we have seen a remarkable culture-change and I am pleased our plan to extend smoke-free areas to outdoor public spaces has received overwhelming public support.

"This is another step in the right direction to de-normalise smoking in Wales."

Unenforceable rules.

The majority of NHS hospitals already have no smoking policies in their grounds but it can difficult to enforce, so a change in the law will give hospitals greater powers to deal with the issue.

Official figures show 8.3million adults in the UK still smoke, down from 10.2million in July 2007.