An independent NHS review has concluded that concerns about the ear, nose and throat (ENT) service associated with Darent Valley Hospital were known to clinicians and managers from 2020, but were not adequately acted upon. The service, run by Medway NHS Foundation Trust, was found to have 8,849 patients waiting to be seen when the full scale of the backlog was uncovered.
Key failings identified
Investigators from NHS England's South East team identified multiple system weaknesses that contributed to the problem. Central among them was the absence of a reliable mechanism to track patients awaiting ENT assessment and treatment. The report found evidence of discussions about the service at meetings over several years but little sign that concerns were escalated to secure corrective action.
"The missed opportunities to act earlier and ensure patients were not waiting unnecessarily are inexcusable."
That comment came from an NHS England spokesperson in response to the review's findings. The investigation also highlighted that clinic capacity had fallen between 2019 and 2025, while staff time was prioritised for urgent cancer referrals. Some patients, the review notes, had waited as long as five years for appointments.
Scale, harm and timeline
While investigators found most patients did not suffer major physical harm, the review recorded that 88 patients experienced what was classified as "low harm" as a result of delayed care. The report traces a timeline in which attention to the service did not appear to intensify until March 2024, and Kent and Medway’s integrated care board only became aware of the full backlog in May 2025.
| Item | Figure / Date |
|---|---|
| Patients found waiting | 8,849 |
| Patients recorded as suffering low harm | 88 |
| Concerns first raised | From 2020 |
| Full scale reported to ICB | May 2025 |
Local impact and next steps
For patients in Dartford and the wider Kent and Medway area, the review underscores shortcomings in oversight and patient tracking for a frequently needed specialty. The report calls for a broader examination of services to ensure similar problems are identified and addressed elsewhere in the region.
Medway NHS Foundation Trust and Dartford and Gravesham NHS Trust were both noted as having been aware of pressures on the service; however, the review concluded the problem did not attract "meaningful attention" until 2024. Investigators said action plans should focus on restoring reliable waiting‑list management, increasing clinic capacity where required and ensuring escalation routes are effective.
Practical information for affected patients
Patients who are concerned about delays in ENT appointments should contact their GP in the first instance to discuss symptoms and ask for an update on referrals. GPs can also escalate urgent cases if symptoms suggest cancer or other serious conditions. Those who believe they have been missed from a waiting list may seek further information from the trust's patient advice and liaison service (PALS) and can expect the trust to provide details of next steps.
- Affected trusts: Medway NHS Foundation Trust (service at Darent Valley Hospital) and Dartford and Gravesham NHS Trust.
- Independent reviewer: NHS England South East team.
- Call to action: a wider regional review of services has been recommended.
The review's findings add to ongoing concerns about pressures across NHS services and the ability of local systems to track and prioritise patients effectively. Local health leaders and the integrated care board will need to demonstrate rapid progress to restore confidence among those whose care has been delayed.
