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Waiting lists set to spiral unless NHS can increase capacity

Fourteen million people could be on NHS waiting lists in England by Autumn 2022, new analysis suggests.

The Institute for Fiscal Studies warns there is a huge hidden backlog of patients who are still yet to come forward for treatment.

The analysis shows that the size of the waiting lists will depend on the ability of the NHS to expand its capacity and treat more patients than it did pre-pandemic.

If that proves impossible, waiting lists could indeed rise to 14 million. 

Last month Health Secretary Sajid Javid said he had been shocked to learn that waiting lists could rise to 13 million patients.

Currently, five million people are waiting for routine operations and procedures.

A record number of patients are currently waiting for surgery – such as hip or knee replacements – with more than 385,000 patients waiting more than a year. This compares to just 1,600 before the pandemic.

New IFS modelling shows that not only are there millions of people who have missed out on care and will come forward over the next year, but the NHS will be potentially hamstrung by infection control measures and the continued need to treat a high number of COVID-19 patients.

NHS waiting lists have grown by less than a million since the start of the pandemic despite there being 3 million fewer planned admissions and 17 million fewer outpatient appointments in the first 10 months of the pandemic alone.

This is because 7 million fewer people joined the waiting list between March 2020 and May 2021 than would otherwise have been expected.

‘Missing’ patients

What happens to waiting lists in the short term will therefore depend crucially on what fraction of these 7 million ‘missing’ patients come back for treatment.

In the longer term, NHS capacity to deal with non-COVID patients will be crucial. Even if only two-thirds of the missing patients return then with capacity at 95% of pre-pandemic levels – much more than the NHS is currently managing – waiting lists could easily exceed 13 million and keep growing.

Expanding capacity will be the only solution to cutting waiting lists in the future, the report suggests.

Finding ways to boost NHS capacity will therefore be a major and pressing challenge for the new Secretary of State and NHS Chief Executive, and will undoubtedly feed into discussions around NHS funding at this autumn’s Spending Review.

Max Warner, a Research Economist at IFS and an author of the analysis, said: “More than 4 million people were on an NHS waiting list even before the pandemic. COVID-19 has only made matters worse, as millions of people have missed out on treatment and millions more haven’t even been referred onto the waiting list to begin with.

“There is a real risk that if the NHS cannot find effective ways to boost its capacity – a challenge at the best of times, let alone after a major pandemic – then much longer waiting lists will be with us for years to come.”

The government said £1bn had given to the NHS this year to clear the backlog.

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