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NHS backlog could start falling ‘well before’ 2024, model suggests

NHS backlog could start falling ‘well before’ 2024, model suggests

By Jess Hacker
15 February 2022

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The NHS backlog for elective care could begin to fall in mid-2023, ‘well before’ the Government’s March 2024 estimate, new modelling has suggested.

In its analysis of the recovery plan, the Institute for Fiscal Studies (IFS) suggested that waiting lists could continue to rise until mid-2023, if only around 30% of ‘missing’ patients return to the NHS.

The DHSC and NHS England’s joint plan estimates that 10 million people ‘stayed away from the NHS’ during the pandemic, in addition to the 6 million-strong backlog.

It considers that if ‘around half’ of the ‘missing demand’ returns over the next three years, NHSE expects waiting lists to start reducing from March 2024.

NHSE also said it hopes to increase capacity by 30% by 2024-25.

But the IFS has suggested it is ‘more likely’ that waiting lists will continue to rise until June 2023 and will start to fall ‘well before March 2024’.

It claims that if NHSE increases its capacity as intended, and only 30% of the ‘missing demand’ returns, the waiting list would peak mid-2023 at 7.3 million people.

By comparison, if 50% and 80% of the missing demand presented, the waiting list would peak at 8.7 million in October 2023 and 10.8 million in December 2023, respectively.

Currently, there is ‘little evidence’ that those who missed care during the pandemic have started to return, suggesting it is ‘more likely’ that waiting lists will follow the lower estimations, it said.

These dates each fall before NHSE’s March estimate, it noted, suggesting this could be because it is unclear when the NHS assumes that increases in capacity will start.

Impossible to clear backlog without staff

Responding to the modelling, the NHS Confederation said ‘we still don’t know the full scale of the backlog challenge’ given the unknown number of patients who put off seeking treatment during the pandemic.

However, the ‘single biggest barrier’ to eliminating year-long waits by March 2025 is ‘the absence of a fully costed workforce strategy’.

Matthew Taylor, chief executive of the NHS Confederation, said: ‘It is impossible to see how backlogs will be cleared by March 2025 without the right number and mix of staff in place. This must be an urgent priority for government.’

NHS leaders and their teams are aware of the ‘debilitating impact’ that long waiting times will have on a patient, but the Government must be ‘honest with the public’ about the issue, he said.

The Government’s plan must also focus on other areas of care with major backlogs, notably mental health and primary care.

Last week, health leaders warned that the plan must not inadvertently burden primary care, noting that general practice must remain ‘central’ to any decision-making on NHS reform.

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