Analysis published by QualityWatch, a joint programme by the Nuffield Trust and the Health Foundation, has concluded that the NHS in England would have expected a waiting list of some 5.3 million people at the end of May 2022 even if the Covid-19 pandemic had not have happened.
QualityWatch’s investigation suggests rather than the pandemic only accelerated a long-term trajectory of declining NHS performance, with the waiting list growing significantly more rapidly than before Covid struck.
The authors of the report emphasise that the NHS backlog cannot solely be attributed to Covid-19 but instead is a predictable consequence of the collision between a pandemic and a health system already stretched beyond its limits. It also lays bare the scale of the challenge awaiting the NHS if it is to recover ground.
QualityWatch: How much is Covid-19 to blame for growing NHS waiting times?, which uses historical data to identify changes in key NHS performance trends before and after the start of the Covid-19 pandemic, found:
- At the peak of the pandemic (March 2021), over 430,000 patients were waiting one year or more for treatment to begin. Tackling one-year waits is a key part of the NHS elective recovery plan, but one-year waiters still make up one in 20 people on the waiting list.
- In May 2022, the number of patients on the diagnostic waiting list reached over 1.5 million. But had pre-pandemic trends continued, we would still have seen a potential waiting list of 1.2 million.
- The number of patients waiting over 13 weeks for a diagnostic test has seen around a 25-fold increase during the pandemic.
- During the pandemic, the number of patients waiting four hours to be admitted to hospitals from A&E units after a decision has been made to admit them (trolley waits) increased rapidly. There was almost a 30 per cent increase during the winter of 2021/2022.
- In March 2022, one in 10 patients waited over two-and-a-quarter hours for an ambulance. This has increased from one in 10 patients waiting over 58 minutes in December 2019.
- Cancer waiting times performance has worsened rapidly. In May 2022, a record low of 61 per cent of patients started treatment for cancer within two months of an urgent referral. The NHS faces a difficult challenge of meeting its own goal to return the number of people waiting longer than two months to pre-pandemic levels.
Commenting on the analysis, Nuffield Trust fellow Jessica Morris said: “There is no denying the seismic upheaval that Covid-19 has had on health and care services, but the pandemic itself cannot be seen as the sole cause of the alarming waits for care.
“Even before the pandemic, waiting times were increasing. At the beginning of the pandemic, over 4.4 million people were on the treatment waiting list. Without covid, and had current trends continued, then at the end of May this year we would likely have had a waiting list of 5.3 million.
“This is reflective of a demand, staffing and resources mismatch that has been in play for a long time. Pre-existing backlogs for routine care, increasing waits in A&E departments, longer ambulance response times and waits for cancer treatment have only been accelerated throughout the pandemic. This has made the NHS recovery challenge even more daunting.”
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