Think tank claims NHS waiting list could reach 10 million by April

Waiting lists for NHS surgery in England could hit 10 million by April, a think tank has claimed while calling for NHS hospitals to use more private sector capacity to reduce delays for patients.

In a new report the right-wing think tank Reform said the worst case scenario for patient waits could see one in six people in England waiting for treatment by April. It said the impact of coronavirus had turned the NHS into a “national Covid service” with six million fewer referrals for treatment in 2020.

It warned the delays in treatments could have dire consequences for patients with an estimated 1,660 additional lung cancer deaths.

But NHS bosses have hit back at the report saying it is inaccurate to say the NHS focused only on Covid, and that despite widespread cancellations it has continued to treat other patients.

Professor Stephen Powis, NHS England’s medical director, said: “The NHS has never been a Covid only service - for every Covid patient in hospital, the NHS is treating three people for other conditions - and it is obviously a disservice to the work done by our staff who have kept services going throughout the pandemic to suggest otherwise.

“Even during the highest point of pressure during the pandemic, the waiting list was actually lower than it was at the same point last year and twice as many elective treatments were delivered as well as around three times as many diagnostic checks in the second wave, compared to the first.”

Predictions that the NHS waiting list would hit 10 million were made last year and proved wrong after hospitals ramped up routine services during the summer – although the second wave of the virus has again led to widespread cancellations including for surgery patients.

The new Reform report claims capacity in private sector hospitals, where NHS England has secured new contracts to take on additional work during the Covid surge, have not been effectively used.

The think tank wants NHS England to mandate the publication of ‘waiting list recovery plans’ by NHS trusts setting out how each hospital will use the private sector.

Reform director of research and report co-author, Eleonora Harwich, said: “We must never have the equivalent of a ‘national covid service’ again.

“This is a system problem and in no way detracts from the heroic effort of NHS staff battling Covid-19. However, the cessation of so much non-Covid care means patients are facing more serious health conditions or disabilities, and some will die prematurely.

“It is essential that the government makes tackling the backlog of undiagnosed disease and untreated illness a national priority.”

The report calls for structural issues in the health service to be addressed and highlights 141,808 worth of hospital bed-days caused by delayed discharges.

It said the lack of capacity in social care and community services was a primary reason for delays and called for more funding for non-hospital settings.

Professor Neil Mortensen, president of the Royal College of Surgeons of England, said he agreed with the idea of recovery waiting lists being published adding: “A huge waiting list has built up over the last year, and it is important for patients and the public to understand how we are working to restore timely access to surgery.”

But he added: “This recommendation lacks ambition in only referencing use of independent sector capacity. So long as we are still caring for thousands of Covid patients in NHS hospitals, then yes we will need continued access to the independent sector’s separate sites. But there isn’t enough private sector capacity to deal with the huge surgical backlog, which could be as high as 10 million patients, as this report suggests.

“We need a new deal for surgery with investment in NHS capacity, to get back to meeting legal waiting times standards.

“Compared to countries like Germany we simply have too few doctors and too few hospital beds. This leaves us exposed, not just to pandemics, but to any infectious disease or severe winter.”

NHS England said the health service completed more than six million elective procedures during 2020 despite coronavirus with hospitals carrying out two cancer procedures for every patient they treated with the virus.

The latest waiting times data showed almost 225,000 patients had now waited more than a year for their operations, with the total waiting list at 4.6 million people.