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Estimated £17bn needed to clear backlog on top of primary care investment

Estimated £17bn needed to clear backlog on top of primary care investment
By Jess Hacker
7 September 2021

The Government will have to spend nearly £17bn if it intends to clear return hospital waiting times to 18 weeks during this parliament, analysis by the Health Foundation has shown.

It comes after the Government yesterday announced a £5.4bn package of emergency funds to help the NHS deal with the Covid-19 pandemic and tackle the backlog. The new analysis, conducted by the Health Foundation’s REAL Centre (6 September), indicates that as much as £16.8bn may need to be spent  during the remainder of this parliament: or before 2024/25.

However, the modelling does not factor in additional investment in primary care to support the recovery, and neither does it consider the ongoing impact of Covid-19, suggesting the actual figure ‘could yet be significantly higher’.

The latest monthly performance statistics from NHS England show that 5.5 million patients were waiting to start treatment at the end of June 2021, of whom 1.7 million were waiting more than 18 weeks.

The Health Foundation has now estimated that to ensure 92% of patients are treated within that time – as set out in the NHS constitution – by 2024/25 would require £4.2bn a year in additional annual funding.

But with this funding delivered, there may not be enough staff, equipment or bed capacity to treat the additional 2.2 million patients annually for the next four years, it said.

Meanwhile, the total additional cost of the Covid-19 for mental health services could range from £1.6bn and £3.6bn which ‘implies a significant additional pressure on general practice’ as most mental health referrals come through primary care.

It added that to meet the increased demand the NHS workforce would need to grow by more than a third over the next 10 years, in addition to current recruitment efforts to manage shortages.

Similarly, a substantial increase of between £3.7bn and £7.9bn in 2022/23 in adult social care funding would be needed to expand care access and pay higher staff wages.

Matthew Taylor, chief executive of the NHS Confederation, described the report as likely just ‘the tip of the iceberg’.

£1bn for the backlog

The Foundation’s report was almost immediately followed by the Department for Health and Social Care’s (DHSC) announcement it would be injecting £5.4bn into the NHS over the next six months.

This would include £1bn dedicated to the Covid-19 backlog and £478m to continue the hospital discharge programme.

Although welcoming this funding, the Health Foundation reminded that this ‘takes Covid-19 spending on the NHS to £15bn this year, similar to the extra cost incurred last year’.

‘But it’s important that the government recognises that this is only the first instalment of the substantial funding needed to put the NHS on the road to recovery,’ Anita Charlesworth, the Health Foundation’s director of research and REAL Centre, said.

‘With the pandemic far from over and huge uncertainties about winter pressures, the government should continue allocating further funding to the NHS for the current year based on need.’

Similarly, the BMA warned that this money will ‘soon run out’, and that this announcement ‘at best’ allows for a good start at tackling the backlog.

‘It will take years – not months – to clear this backlog, in addition to concerns of new winter pressures ahead,’ Dr Chaand Nagpaul, BMA chair of council, said.

‘What the NHS desperately needs from this Government is long-term sustained funding to give us the capacity to address the totality of this backlog plus give the NHS a chance to meet ongoing health needs of our nation.’

It comes as the Prime Minister has announced plans to raise National Insurance tax by around 1.25% as a means of funding social care. The reform has been met with criticism by Labour – who have claimed it would target young people and low-income earners – and by unions including GMB, the union for carers.

Rachel Harrison, GMB national officer said: ‘We all know our crumbling social care system desperately needs more cash.

‘But raising regressive National Insurance – which takes money from the pockets of the lowest paid workers, is not the way to do it.’

She added: ‘The largely women workforce in social care deserve no less than the average UK wage, £15 an hour. Government and employers must make this a priority.’

This all comes as trusts and NHS staff report they are falling under ‘the highest pressure they have ever known’.

A recent study revealed that as many as three-quarters (73%) of trust leaders are concerned that their plans to address the care backlog will be disrupted by anticipated winter pressures.

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