HEALTHCAR E DE LIVE RY
5.83 million patients on the waiting list for elective care, of whom 1.95 million patients had been waiting for more than 18 weeks, including 301,000 waiting for more than a year. By June 2021, NHS cancer services activity had recovered to pre-pandemic levels. However, since the start of the pandemic (up to September 2021), patients with an urgent GP referral for cancer were more likely to be delayed – 26% had to wait more than 62 days for treatment to start.
Millions of people have also avoided seeking or been unable to obtain referrals for healthcare during the COVID-19 pandemic. The NAO estimates that there were between 240,000 and 740,000 “missing” urgent GP referrals for suspected cancer during the pandemic. In addition, the NAO estimates that up to September 2021 between 35,000 and 60,000 fewer people started treatment for cancer than would have been expected. Over the same period – March 2020 to September 2021 – the NAO estimates there were between 7.6 million and 9.1 million fewer referrals for elective care. The NAO recognises that there is inherent uncertainty about these estimates. It is also uncertain how many of the “missing” cases will return to the NHS to seek treatment and over what time period, though clearly many will. The NHS will need to increase its activity to meet this surge in demand. Even if it can adapt, the scale of the challenge it faces is daunting. If 50% of “missing” referrals for elective care return to the NHS and its activity grows only in line with pre-pandemic plans, the elective care waiting list will reach 12 million by March 2025. If 50% of “missing” referrals return and the NHS can increase activity by 10% more than was planned, the waiting list in March 2025 will still be 7 million. Addressing backlogs and reducing waiting times will be a multi-faceted challenge for the NHS. Announcements about additional funding in September and
October 2021 answer some questions but important uncertainties about the road to recovery remain. To increase the numbers of hospital beds, nurses and doctors beyond the levels already planned could take years because of the time required for capital projects and for training. The ongoing COVID-19 pandemic could also continue to affect bed and staff availability in unexpected ways and at short notice. Commenting on the report, David Hare, chief executive of the Independent Healthcare Providers Network, said: “The NAO report highlights the significant pressures on the NHS, and that despite the tireless efforts of healthcare staff all around the country, millions of patients are finding it increasingly difficult to access the care they need. “Given the scale of the challenge, it’s vital that the Government’s forthcoming elective care recovery plan ensures that all available resources are deployed in order to tackle the backlog. This includes the use of independent sector providers, which
the NAO’s report makes clear played a key role in ensuring non-COVID services could continue during the pandemic, with the delivery of over 3.3m NHS procedures.” Nuffield Trust’s director of research, John Appleby, added: “The report from the NAO is right to warn that the growing backlog of care will, unfortunately, get worse before patients start to see improvement. This warning is even starker in the face of continuing uncertainty about the progress of the pandemic and the seasonal pressures on the NHS over the next few months. “The truth is that the waiting list for routine surgery and treatment was growing well before the pandemic: 4.5 million patients were waiting before March 2020 and waiting times targets have been consistently missed for some years. Underinvestment in NHS equipment and facilities and the lack of long-term planning on staffing and training meant the UK’s health service went into this crisis with fewer beds and staff than many other international systems. It is these constraints going in that will slow the NHS’s path to recovery. “As the NAO points out, recovering the backlog of patients who missed treatment, while also coping with rising demand, will mean the NHS will have to work harder than ever. The key constraint will be staffing. The Government will need to be realistic about the time it will take to recover to pre-pandemic levels, let alone once again meeting their own waiting time targets. There will be difficult trade-offs ahead for staff over recovery in the short-term against the long-term effects of this momentous task on the existing workforce.”
CSJ
Reference 1 Accessed at:
https://www.nao.org.uk/wp-content/ uploads/2021/07/NHS-backlogs-and-waiting- times-in-England.pdf
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