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Covid not to blame for backlog, study finds

Covid not to blame for backlog, study finds

By Jess Hacker
5 September 2022

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The NHS backlog would have likely hit 5.3 million people at the end of May 2022, regardless of the pandemic’s impact, new analysis has found.

The current waiting list for elective care stands at a record-breaking 6.7 million people, with around 355,774 patients waiting more than a year after referral.

However, analysists from the Nuffield Trust and the Health Foundation have today warned that the scale of the NHS backlog cannot be solely attributed to Covid-19.

Instead, it ‘accelerated the trajectory the NHS was already on’, they said, adding that it would be ‘misleading’ to blame the pandemic in isolation for the crisis.

According to the QualityWatch report – a research programme led by the two charities – the scale of the backlog is a ‘predictable consequence’ of the pandemic hitting a health system stretched beyond its limits.

Using historical data to identify changes in NHS performance trends before and after the pandemic, the authors noted that the total waiting list for elective care grew from around 2.5 million in April 2012 to 4.6 million in February 2020: a month before the first lockdown.

If the waiting list were to grow in line with pre-pandemic trends, the authors would have expected the waiting list to stand at around 5.3 million in May 2022, 1.4 million fewer than the current figure.

They also said: ‘The current trends point to intensifying pressures in every part of the system that will not go away easily. This makes many of the recovery targets a steep ask to balance alongside ongoing waves of the virus, and persistent staff shortages that are worsening in key areas. Add to this a tightening financial picture, as the NHS faces a real-terms budget cut this year and will have to do even more with less.’

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’, leading to an ‘even more daunting’ recovery challenge, she added. The authors of the report stressed that this is not to say that the NHS has not risen to the challenge, noting that services ‘have acted quickly and pulled out all the stops’ to find efficiencies and adapt service models to see as many patients as possible.

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