NHS England review: why 9,000 patients were missing from list

Concerns about an ear, nose and throat (ENT) service were raised five years before a backlog of nearly 9,000 patients was discovered, an NHS review has found.

Despite doctors and managers knowing about problems in the service run by Medway NHS Foundation Trust, the review found no evidence that concerns were acted on properly, as first reported by HSJ, a publication for healthcare leaders.

“The missed opportunities to act earlier and ensure patients were not waiting unnecessarily are inexcusable,” said an NHS England spokesperson.

Some patients had waited up to five years for appointments. As a result of delays, 88 patients suffered “low harm”.

What went wrong?

NHS England’s South East team found the absence of a single, reliable waiting list for ENT patients was the main reason these long waits went unnoticed for many years. It also highlighted missed opportunities for earlier escalation, weaknesses in data systems and governance and an inadequate service agreement.

It said clinicians at Medway NHS Trusts and managers at both Medway and Dartford and Gravesham NHS Trusts were aware of concerns about the service from 2020 onwards. Issues were discussed at meetings, but there was no evidence they were escalated or addressed.

The review also found that reduced clinic capacity between 2019 and 2025 meant fewer patients could be seen while staff focused on urgent cancer referrals.

Some evidence suggested concerns had been raised with senior leaders at Medway from 2020, but the report said the issue “did not appear to attract meaningful attention” until March 2024.

The review also found Kent and Medway’s integrated care board was aware the service was under pressure for several years, although the full scale of the backlog was not reported until May 2025.

Clearing the backlog

The report calls for a wider review of how ENT services are organised across Kent and Medway. Medway NHS Foundation Trust said it had checked all affected patient records, contacted those involved and created a single waiting list.

The trust said all patients caught up in the backlog had been seen, treated and discharged by the end of May “thanks to an extraordinary effort by colleagues across the service, and with external support”.

Dartford and Gravesham NHS Trust apologised to patients and said it should have raised concerns within the trust more effectively.

Have you been affected?

Not every delay for an appointment is the result of medical negligence. However, where healthcare professionals fail to provide an appropriate standard of care and that failure causes avoidable harm, patients may be entitled to seek independent legal advice.

Pursuing a medical negligence claim is not simply about financial compensation. For many people, it provides an opportunity to understand what happened, access specialist support if appropriate and help ensure lessons are learned to improve patient safety for others.

NHS England’s review of the ENT service run by Medway NHS Foundation Trust has highlighted the fact that sometimes things go wrong at a huge scale for many years before they are addressed, and processes must be improved.

The failings have been identified and the backlog has been cleared. The challenge now is ensuring nobody goes missing from a waiting list again. Learning from the past is essential if future patients are to receive the ENT appointments they need in a timely manner.

Strengthening systems

Medway NHS Foundation Trust is working with its system partners to act on the review’s recommendations, and a detailed report about this will be presented to its board on 1 September and published on its website.

“We are committed to acting quickly when things go wrong, learning from what has happened, and strengthening our systems and culture so that we provide the quality, timely care that our patients and families rightly expect,” states the Trust.

How Attwaters can help

If you were one of the thousands of patients who waited an unacceptably long time for a first or follow up ENT appointment at Medway Maritime Hospital in Gillingham or Darent Valley Hospital in Dartford, please talk to us.

Our experienced Medical Negligence team provides compassionate, practical advice to help you understand whether your care fell below an acceptable standard. We will listen to your experience, explain your legal options clearly and support you throughout the process with sensitivity and expertise.

To speak to a member of our Medical Negligence team in confidence, please contact Attwaters today.