With Covid-19 causing unprecedented backlogs across the health sector, Public Policy Projects Coalitions Analyst Dinith David outlines the scale of the challenge facing the NHS.

As the UK population started to don their facemasks and work from home in the early stages of the pandemic last year, the NHS was already on its knees.  
In 2004, the Labour Government introduced a key benchmark for acute treatment wait times of 18 weeks. This starts at the point of a GP referral and stops after the patient is discharged. An ambitious plan, but by February 2016 this benchmark was met as the number of patients who waited more than 18 weeks was 269,589. However, the NHS has been consistently missing these targets for the last four years. Of the 4.4 million people on a waiting list in January 2020, 730,000 of them were waiting beyond the 18-week target for treatment – almost one in six patients.1  

The pandemic has pushed an already vulnerable system to the brink. The shutdown of multiple non-Covid-19 services and an increased reluctance amongst patients to seek specialist care has meant that there is an ominous and growing backlog – the effects of which will be felt years to come,2 according to David Maguire of the Kings Fund. Research from the British Medical Association has revealed the full extent of the problem. They estimate that between April 2020 and February 2021 there were 3.24 million fewer elective procedures compared to 2018-2019 statistics.3 This has translated to treatment odysseys that on average last about 12.6 weeks.4

This has had a considerably detrimental impact on the lives of patients. Vice President of the Royal College of Surgeons, Tim Mitchell has stated that many patients in the UK will be “waiting in limbo” and in considerable pain as they await treatment.5 

The recent news that over 4.7 million people are awaiting elective treatment should be considered a wake-up call for the Government to re-examine how care is delivered beyond Covid-19. Part of this is a fundamental re-think of the NHS Long Term Plan. With the Plan being published in 2019, it is no longer reflective of the uphill battle the NHS faces on the growing backlog of care. This update must further consider the cost of tackling this challenge.  

Financial modelling from the Health Foundation estimates that treating 92 per cent of patients within 18 weeks would cost the Government between £5.2 billion and £6.8 billion, if they were to eliminate the backlog by the end of March 2024.6 To tackle this, the Health Foundation estimates that, if the backlog of patients waiting more than 18 weeks was evenly distributed across the next four years, the NHS would need to treat over 40,000 additional cases a year.

For a healthcare system that is in the midst of the biggest workforce crisis in a generation, this is a tall order. According to the Kings Fund, NHS hospitals and primary care services are now reporting shortages nearly 84,000 full time staff, with 38,000 of these vacancies being frontline nurses.7 The Covid-19 recovery plan, which set out £8.1 billion in March8 to help recover patient services will be useful at tackling this issue, tackling staffing shortages and the significant bottlenecks in diagnostic services must become a top priority.9  

However, there could be light at the end of the tunnel yet. With over 40 million people already vaccinated for Covid-19 by mid-February,10 there has been a considerable drop in patients hospitalised by Covid-19 and a significant reduction in the demand for beds and overall pressure on the system. To tackle this “sea of need”,11 there has to be a considerable re-think of the way healthcare is delivered in this country.

It is for this reason that Public Policy projects looks to create a one-of-a-kind coalition which brings together leading experts and build consensus on a universal healthcare system. This coalition looks to target the care backlog and create effective policy recommendations through thought leadership in health care. The NHS faces significant challenges in the coming years, but through effective dialogue and tangible policy recommendations, a robust and efficient healthcare system can be realised.