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‘System-wide waiting lists’ could help primary and secondary care tackle backlog, NHS Confederation suggests

by James Hacker
8 March 2021

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‘System-wide waiting lists’ could improve discussions between primary and secondary care as to how patients are prioritised for treatment it has been suggested, as new analysis indicates a ‘hidden’ elective care backlog.

The NHS Confederation has suggested that the ‘true demand for elective care’ could be much larger than expected when referrals from GPs return to pre-pandemic levels, after it commissioned analysis which indicated the treatment backlog could reach 6.9m appointments by the end of 2021.

At the end of 2020, the treatment backlog for non-urgent procedures stood at 4.5m people, the NHS Confederation said, noting that referrals for elective treatment dropped by 30% to 14m last year.

It added that this was due in large part to the fact that ‘services and wards had to be repurposed and staff had to be diverted to support the immediate demands’ of the pandemic.

System-wide waiting lists

The NHS Confederation suggested strengthening the relationship between primary and secondary care planning to tackle the backlog.

‘Our members want to see whole-system thinking to manage waiting lists between trusts, and deeper partnerships with primary and community care, supported by real-time patient data,’ it said.

A new plan ‘must recognise’ that only by working at a system level can the NHS ‘maximise efficiencies, allow for mutual aid between trusts and provide a better service for patients’.

In order to achieve this, NHS Confederation said, the NHS needs an agile, clinically-led picture of ‘the state of the backlog in each system’.

It added: ‘It also requires system-wide waiting lists and a single picture of the truth. This will enable clinically led discussions on prioritisation between primary and secondary care, as well as fluid lists that recognise the individual circumstances of each patient, their co-morbidities and any decline in condition.’

The NHS Confederation said that the NHS’ prioritisation of urgent and emergency procedures has meant that ‘people at higher risk are being supported by primary and community care when these services are already stretched’.

Danny Mortimer, chief executive of the NHS Confederation, said: ‘Health leaders are concerned that we may be scratching the surface of this waiting list if further referrals come through at a time when coronavirus pressures are still high, the workforce is in a very fragile state, and when capacity is still so constrained.’


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