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NHS faces a colossal challenge in tackling a record-high backlog for surgery and care

By Ross McWilliams, a medical negligence lawyer at Irwin Mitchell

A report from the National Audit Office (NAO) warns that the already huge backlog for NHS care in England will continue growing for years and could hit anywhere between 7 million and 12 million by early 2025.

Efforts to stop the waiting list soaring from its current 5.83 million will be hampered by the NHS having fewer beds, doctors and other staff. That could prevent it from being able to keep up with the growing numbers of people who are likely to require care in future, particularly those awaiting elective surgeries such as hip and knee replacements, cataract removal, and those awaiting cancer treatment.

Missing patients

The reports suggests that the key to how much progress the NHS can make is how many of the estimated 7.6 million to 9.1 million “missing” patients, who have not sought care during the pandemic, finally do so in the near future. While the report says that number is unknown, “clearly many will”.

The report considers some possible scenarios and the likely impact:

  • If 50 per cent of ‘missing’ referrals for elective care return to the NHS and its activity grows only in line with pre-pandemic plans, the elective care waiting list will reach 12 million by March 2025.

  • If 50 per cent of ‘missing’ referrals return and the NHS can increase activity by 10 per cent more than was planned, the waiting list in March 2025 will still be 7 million

The solution

The report comes as NHS England and the Department of Health and Social Care finalise an “elective recovery plan”, which will set out in detail how hospitals will tackle the growing number of people who are having to wait for care.

The plan will propose scrapping tens of millions of hospital outpatient follow-up appointments to free up doctors to do more surgery, a greater use of private hospitals to treat NHS patients, and some patients being offered the chance to have their operation outside their home area.

This is not a new problem; the waiting list of people who should be treated within 18 weeks already stood at 4.43 million when the pandemic struck in March 2020 and that the target of dealing with 92 per cent of them within that timeframe had been missed since 2016.

However, the number of people forced to wait more than a year for treatment - which previously happened rarely - rocketed from 1,600 in February 2020 to 301,000 in September this year. 

An NHS England spokesperson said: “Treating more than half a million patients in hospital for Covid, as well as delivering a world-leading vaccination programme, has inevitably had an impact on some routine and non-urgent care. Yet since the pandemic began the NHS has performed millions of elective procedures and over 450,000 people have started treatment for cancer.”

Patient Safety

Many of us will have experience of facing long waiting lists for treatment on the NHS but clearly the pandemic has had a significant impact on a service which was already stretched to the limit. 

One of the most concerning aspects to this issue, certainly from a patient safety perspective, is the impact on those requiring treatment for cancer and those who have not sought medical treatment for suspected signs of cancer but otherwise would have done.

Find out more about Irwin Mitchell's expertise in supporting people and their families following a care issues and diagnosis delays at our dedicated medical negligence section.

The already huge backlog for NHS care in England will keep growing for years and could hit anywhere between 7 million and 12 million by early 2025, the National Audit Office (NAO) warned today.

The NHS is facing a “daunting” task in operating on all those awaiting surgery and reducing the long waits for care many people are now facing, the NHS Whitehall spending watchdog said.”