MPs have called on the Government and NHS England to publish their plans for dealing with treatment backlogs and long-waiting times by the end of October, following the disruption caused by Covid.
In an inquiry on the early pandemic response, the Health and Social Care Select Committee concluded that Covid-19 patients were ‘rightly prioritised’ but the focus must now be on restoring routine services, given the ‘substantial increase’ in missed, delayed and cancelled appointments.
The report said the NHS cannot act ‘exclusively’ as a Covid-only service, but that it was not clear what practical steps the Government and NHS England are taking to address the backlog.
The absence of a public plan ‘may be contributing to the inability of local trusts to inform patients when they can expect to receive a long-awaited medical procedure,’ it added.
Backlog impact
Dame Cally Palmer, NHS England’s national cancer director, told the inquiry that in April urgent cancer referrals had reduced by 62% compared to pre-pandemic levels, while substantial disruption to chemotherapy services meant appointments were ‘running at about 70% of normal levels’ on 1 May.
A study by DATA-CAN, mentioned in the report, showed that up to two million routine breast, bowel and cervical cancer screenings may have been missed during the pandemic.
The study concluded that there could be 35,000 avoidable deaths within a year if delays to cancer services continue.
Claire Murdoch, NHS England’s mental health director, told MPs that mental health referrals reduced by roughly 30% and 40% at the beginning of May.
In written evidence, Mind, the mental health charity, said: ‘Vital mental health services being scaled back and people being unable to get support is likely to have led to people becoming more unwell and more likely to reach crisis point.’
Changes to support NHS and care staff
The inquiry also considered issues that have impacted the health and social care workforce during the pandemic, including the risk of falling ill from the virus itself.
MPs said routine testing for all NHS staff should be introduced ‘as quickly as capacity allows’ and urged the Government to publish details on how and when this can be achieved.
On concerns raised about staff fatigue and burnout, the committee said: ‘We also believe more must be done to support the mental wellbeing of staff. Helplines, apps, webinars and managerial training will all be of value but with many members of staff facing much more severe and sustained pressures on their mental health, more substantive action will need to be taken to support the wellbeing of staff, particularly before the busy winter period.’
The MPs added that they felt concerned that the recent NHS People Plan has not set out ‘future workforce recruitment objectives’ and has therefore not addressed workforce capacity – one of the biggest issues facing staff.
‘We note that the People Plan states further announcements will be made once the Government has confirmed funding arrangements for the NHS,’ the report added.
The report also reviewed issues relating to racism within the NHS, in light of recent events. The inquiry heard that some black, Asian and minority ethnic (BAME) staff face discrimination, and concluded that levels of diversity ‘must be improved’. MPs urged the NHS to increase its efforts to tackle it.
‘Stronger focus on tackling inequalities needed’
Richard Murray, The King’s Fund chief executive, said: ‘The committee has outlined vital lessons that need to be learnt as health and care services brace for a second wave of the virus.
‘As well as taking a toll on NHS services, the pandemic has ruthlessly exposed deep inequalities in our society and fundamental weaknesses in our adult social care system. Alongside the NHS workforce, social care staff also need to be regularly tested and provided with adequate resources to manage the spread of the virus as they offer support to people in their own homes and in residential care.’
He added: ‘Covid-19 has had a disproportionate impact on some groups in our society, such as Black and ethnic minority communities, older people, those with disabilities and people living in deprived areas. As the health and care sector faces a second wave and looks to the future, there must be a much stronger focus on tackling the inequalities exposed by the pandemic and its economic and social consequences.’
