A reduction in elective care waiting lists and waiting times is ‘unlikely’ to lead to a ‘meaningful’ fall in health-related benefit claims, according to analysis by the Institute of Fiscal Studies (IFS).
The analysis, called The relationship between NHS waiting lists and health-related benefit claims, looked at the number of working age adults receiving health-related benefits between November 2019 and May 2024, and the NHS waiting list for pre-planned hospital care.
It found that though there was a 40% increase in those receiving health-related benefits and a 67% increase in the NHS waiting list for pre-planned hospital care, that there was ‘no clear relationship’ between the two.
The analysis said: ‘In the vast majority of cases we examine, we find no evidence of a meaningful relationship between the two: areas that experienced larger increases in NHS waits did not, on average, experience larger increases in the number of working-age adults receiving health-related benefits.
‘This is especially true when we account for differences in population growth across areas.’
It added: ‘The breadth and consistency of our results lend weight to the conclusion that NHS performance – at least as captured by measures of waits for pre-planned hospital care and some forms of mental health care – has not been a major factor behind the large increase in the number of working-age adults receiving health-related benefits.’
However, the authors emphasised the study did not look at performance in other parts of the NHS, such as primary, community or emergency care.
They also said that this analysis does not mean that the waiting times for NHS care are ‘unimportant’.
‘Rather, we conclude that they appear to be unimportant in explaining recent trends in health-related benefit claims. Waiting longer for care may still worsen the patient’s ultimate health outcomes, in at least some cases.
‘And longer waits very likely have a deleterious effect on the patient’s well-being more generally – reason enough to think bringing down waiting times is important, even if doing so only leads to a small reduction in the subsequent number of health-related benefit claims.’
It suggested that recent policy initiatives to bring down waiting lists in the areas of highest economic inactivity were therefore ‘unlikely to have much effect’ on disability benefit claims.
Responding to the analysis, Dr Layla McCay, director of policy at the NHS Confederation, said: ‘While there is no doubt many people on health-related benefits will be waiting for NHS treatment, the evidence from this new IFS analysis is that rising waiting lists for hospital treatments have not been fuelling the rise in working-age adults claiming benefits.
‘It is clear that there are many factors that can impact people’s physical and mental health – including poverty, insecure housing and unemployment. We know poor mental health is the main driver of increases in economic inactivity in younger people and there are an estimated 1.6 million people waiting for mental health community care that will not be in hospital or Talking Therapy waiting list figures.’
She added that tackling the waiting lists was good for patients and the economy, but that this was further evidence of the need for cross-government collaboration and investment on health policy, as ‘most policy that impacts people’s health is made outside the NHS’.
‘This should be evidence-led and focused not just on the NHS, but across the social determinants of health to improve the health of our nation as part of the prevention agenda,’ she said.
Impact of deprivation
It comes as the UK Health Security Agency (UKHSA) last week released a report on the health inequalities in England caused by infectious diseases and environmental health hazards.
The Health inequalities in health protection report showed that those living in the 20% most deprived areas of England are almost twice as likely to be admitted to hospital due to infectious diseases than those in the least deprived. This costs the NHS up to £1.5bn a year, the analysis found.
Those in the North West are 30% more likely to be hospitalised for an infectious disease compared to the average across England, and 50% more likely than those in the South East.
The analysis also showed that those living in deprived areas have twice the emergency hospital admission rates for respiratory diseases than those living in the least deprived areas. For tuberculosis, the rates are seven times higher in the most deprived areas. And for sepsis, hospital admission rates are up to two and a half times higher for the most deprived areas.
These communities are also disproportionately impacted by radiation, chemical, climate and environmental hazards, according to the analysis.
Inequalities were also seen by ethnic group, with emergency admission rates for tuberculosis 29 times higher for those who self-reported as being in the Asian other category, 27 times higher for Indian, and 15 times higher for Black African compared to White British people.
Inclusion health groups, such as those seeking asylum, people in prison and those who experience homelessness are also disproportionately impacted by a range of infectious diseases, however they are often not visible in routine health surveillance data, it added.
Dr Leonora Weil, deputy director for health equity and inclusion at UKHSA said: ‘The report reveals some stark facts on the state of inequalities in health security faced by some people, in particular those living in the most deprived communities and certain areas of the country, some ethnic groups, as well as excluded groups such as those experiencing homelessness.
‘These health protection inequalities – where there are poorer health outcomes based on where you live, your socio-economic status or ethnicity are avoidable, pervasive, and preventable. That is why it is so important to shine a light on these findings to increase action to support communities to live longer and in better health.
‘Going forward our data and analysis of the evidence will help us, and our partners apply a health equity lens to all our health security work, to inform how we better target effective health services and wider interventions to those most at need.’
It comes as a recent report found that the NHS faced record, or near-record, levels of operational pressures across urgent and emergency care this winter, and performed far worse than before the pandemic.
