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Tackling backlog has pushed ‘every part’ of the NHS under pressure

by Jess Hacker
13 August 2021

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Complications caused by the backlog of care is just one factor placing the NHS ‘under huge pressure’, as new data reveals the NHS waiting list has increased further.

Published yesterday (12 August), the latest monthly performance statistics for NHS England indicated that 5.5 million patients were waiting to start treatment at the end of June 2021, up from 5.3 million patients the month before.

Of those, 304,803 patients were waiting more than 52 weeks to start treatment, while 68.8% of patients waited up to 18 weeks, failing to meet the NHS Constitution’s standard that 92% of patients should be treated within that timeframe.

The stats also revealed that there were 15,462 incomplete pathways for mental health services, 267,256 for paediatric services, and 387,760 for general surgery services.

In a Twitter thread shared yesterday (11 August) anticipating today’s statistics, NHS Providers chief executive Chris Hopson warned that there a combination of six factors pressuring ‘every part of NHS’, including primary care and trusts.

In addition to Covid-related care, these factors include the speed at which trusts are tackling the backlogs and the associated workload for staff, low bed capacity, increasing numbers of staff self-isolating or on annual leave, and demand for urgent care.

He added that ‘some CEOs are saying that their trust is under the highest pressure they have ever known’.

Pressure beyond Covid caseload

Elaborating in a separate statement, Mr Hopson said: ‘Trust leaders are clear that, to measure the full extent of current pressure on the NHS, it’s vital to look at the full range of demand and staffing pressures, not just the Covid caseload.’

He said that the ‘full pelt’ speed at which trusts are attempting to tackle the backlog ‘inevitably puts pressure on staff, beds and equipment’, adding that this is a ‘major challenge given the NHS didn’t have enough beds before the pandemic started’.

Meanwhile, staffing levels have become a ‘critical issue’ across the NHS, with large numbers having to self-isolate amid the ‘peak summer leave period’.

He also noted that demand for urgent care is exceeding pre-pandemic levels, particularly in ‘holiday hotspots’.

Last week, NHS England warned practices against referring holidaying patients to a local service.

While the 5,000 Covid-19 patients admitted to hospital over the last fortnight is ‘lower than many were predicting’, it has continued to place pressure on hospitals with high bed occupancy.

‘For example, the higher level of emergency admissions many trusts are seeing and the pressure on beds from backlog recovery,’ he said.

Dr Vishal Sharma, BMA consultants committee chair, said: ‘The Government continues to say that tackling the backlog is a priority, but there is no quick fix in a health system that was understaffed and under-resourced long before Covid arrived.’

He added that clearing the waiting lists will require a ‘significant boost to investment’, and will depend on the work of doctors and colleagues who ‘we know are in short supply, with the BMA estimating that England has 50,000 too few doctors to meet demand’.

This comes days after new modelling by the Institute for Fiscal Studies found that concerns that the NHS waiting list could reach and exceed 13 million people are ‘well within the realms of possibility’.

A separate report from the British Heart Foundation found that cardiac waiting lists alone could take five years to clear, with the number of people waiting for heart care and diagnosis could more than double within two years if left unchecked.

Similarly, a recent study revealed that as many as three-quarters (73%) of trust leaders are concerned that their plans to address the care backlog will be disrupted by anticipated winter pressures.

This story first appeared on our sister title, Healthcare Leader.