The NHS waiting game
It’s understandable that NHS waiting lists for elective care took a huge hit during COVID. I believe no one can criticise policy makers for the decisions they made during those early weeks of March 2020 – the Government was trying to make policy decisions with no real data to guide them, operating in genuinely unprecedented times (annoying as that phrase did become over the following two years).
But with the great benefit of hindsight, the impact of delaying non-urgent care and the catch up of what the NHS has termed “missing demand” is without doubt enormous. I believe it’s going to be an almost impossible task to accurately quantify the true impact - it feels like a massive guessing game that even the most experienced of actuary would not want to be tasked with.
Some data is starting to come through now. In a report published in February by the NHS, “Delivery plan for tackling the COVID-19 back log elective care[i]”. The Chief Executive of the NHS, Amanda Pritchard set out her plan to eliminate waits of more than 12 months by 2025 and to ensure that 95% of diagnostic tests are received within six weeks.
To support elective recovery the government has committed to spend an additional £13.9billion for new beds, equipment and technology which is in addition to the Elective Recovery Fund and Targeted Investment Fund which collectively provides £2.7billion of investment to ‘drive up and protect elective recovery’.
But 2025 seems a long way off, waiting 12 months for an operation still seems unreasonable and surely the UK’s diagnostic industry can scale up faster than that? Particularly in light of the Prime Minister’s recent admission that the UK was spending £2 billon per month on COVID-19 tests at the level of testing we experienced in January 2022[ii].
It’s fair to say that NHS waiting lists are not a new topic - but it’s a subject that the media is committing significant column inches to and it’s rousing great fury from the general public.
In a recent article published by the Independent Dr Tim Cooksley, president of the Society for Acute Medicine, said: “Urgent and emergency care services remain under significant pressure with high numbers of emergency presentations, increasingly complex patients with multiple health problems, and delays in patient discharges due to social care challenges.
“In addition to this we have increasing waiting times for non-urgent services resulting in a greater proportion of patients deteriorating while waiting for intervention and thus requiring acute care. Proposals announced by the Health Secretary to tackle the six million patients on waiting lists are of clear importance. However, today’s figures highlight once again the huge pressures urgent and emergency care is under.
“Emergency and non-urgent care are reliant on each other, and neither will perform satisfactorily if the other is under significant strain, and we risk an ongoing vicious cycle of delays for timely patient care.”
We know that waiting lists were high pre-pandemic, reported at 4.4milion before Covid-19, so we need to look to solutions that are both new since the pandemic, as well as the more established processes that have been in place for decades before the pandemic hit.
Let us firstly capture the different routes by which we can increase capacity which are set out neatly in the report.
1. Growing and supporting the workforce
2. Using digital technology and data systems to free up capacity
3. Safely adapting infection prevent and control measures
4. Making effective use of independent sector capacity.
It is points 2 and 4 that particularly capture my attention. The NHS has always worked with the private sector. Not only can they physically help to increase capacity by delivering the services themselves, but the private sector can ‘support the NHS’s ambition for innovation and efficiency’.
As a specialist exec search firm within the MedTech and Life Science sector I am fortunate enough to have first-hand exposure to a number of firms who have been successfully tackling the backlog on behalf of the NHS for decades. I am sure there are lessons we can learn from these businesses, and we should be encouraging dialogue between the public and private sector at all levels.
Summary
There is no one single answer to how we clear the backlogs. But what needs to run through every solution is both innovation and accountability. We must be creative in our approaches, finding solutions and drawing on the amazing community around us including the brilliant academics from across our university and research centres around the UK. We must also be hard with ourselves, carefully examine data so that when things aren’t working, we don’t continue to paper the cracks.
[i] https://www.england.nhs.uk/coronavirus/publication/delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care/[ii] https://www.telegraph.co.uk/politics/2022/02/20/free-covid-testing-limited-2bn-monthly-cost-high-says-boris/