6 July 2022
New research is pointing to lengthy waiting times on the NHS being something that people will be expected to put up with for a long time.
There was some speculation that the recent increases in waiting times could be attributed primarily to the problems experienced during the Covid-19 pandemic and that the recovery once capacity returned to normal would be fairly rapid.
Two pieces of recently published research indicate that there are fundamental structural issues in the NHS which are likely to see waiting times continuing to increase and being maintained in a sustained fashion.
Surgery waiting lists will triple by 2030, triggering a “population health crisis”, unless there is a huge increase in NHS capacity, according to experts from Birmingham University who have said efforts to reduce hospital backlogs are not enough and that it is “impossible” for the existing frontline workers to tackle increasing waiting lists.
The in-depth analysis of the challenge facing hospital waiting lists in England has revealed 4.3 million people need invasive surgery or procedures such as endoscopy, the largest number since 2007.
Of these, an estimated 3.3 million are on a “hidden waiting list”, likely to need treatment but yet to be identified by the NHS due to the impact of the pandemic.
More than 2.3 million people, 53 per cent of the waiting list, are of working age, meaning their delayed diagnoses and treatments could have an impact on the economy.
Without a substantial increase in NHS capacity, the team behind the work say the total figure for those waiting for surgery in England could rise to 14.6 million by 2030.
Eliminating this would need a 50 per cent increase in activity across the NHS, based on pre-pandemic performance and require £9.2 billion of extra spending — the equivalent of £163 per person in England.
Aneel Bhangu, 40, senior lecturer in surgery at Birmingham University and consultant colorectal surgeon at University Hospitals Birmingham NHS Foundation Trust, the lead author of the study, said: “The real crisis is this hidden waiting list. I know there are people out there now with diseases and conditions that need treatment but they cannot navigate through the system.
“Taking the most optimistic scenarios, a [significant] waiting list is inevitable by 2030. The percentage increase in activity required per year to combat that, bearing in mind the needs of the population, is impossible from a frontline point of view.
Dmitri Nepogodiev, 33, a public health registrar and co-author of the research, questioned the NHS’s prioritising of waiting lists.
“Some people will be able to get to work and continue with their normal activities but there will be a proportion of these patients, because they are delayed in getting their treatment, who will have worsening symptoms and a worsening quality of life and that will have a big knock-on effect,” he said. “I think this is a potential public health crisis over the next five years.”
The NHS waiting list for routine treatment hit 6.5 million in April, including outpatient appointments and non-surgical treatments. The Birmingham research focused on invasive procedures and surgery and the full report is available here.
Analysis recently published by The Spectator uses NHS modelling techniques which they obtained in February 2022. Applying those techniques to the NHS waiting list at the end of April 2022 produces a scenario of between 10.7 million and 9.2m people waiting in March 2024, up from the current 6.5m.
