Providing timely care has been a consistent challenge throughout the NHS’s history – and one that Covid-19 has made several magnitudes more difficult.
At the start of the year – before the worst of the pandemic hit the UK – 16.5% of patients waited more than 18 weeks from a referral for elective treatment, more than double the national target. This varied slightly by region, ranging from 15% of patients in the Midlands to 18% of patients in the East of England and the South West.
As Covid-19 unfolded and hospitals cancelled all routine and non-urgent care to free up acute care capacity and help keep transmission rates as low as possible, the number of patients enduring long waits for elective care went up dramatically. By June 2020, nearly half (48%) of patients needing elective care were waiting more than 18 weeks, with similar waiting times across all regions. Patients awaiting specialised services for things like chemotherapy, orthopaedics and oral surgery have seen the largest increase to waiting times. NHS England commissions services for a range of rare and complex conditions, and 60% of patients in need of these treatments were waiting more than 18 weeks as of June to start elective treatment (compared to 19% in January 2020).
The regional picture may limit some of the policy choices we have for managing waiting times and reducing the number of patients affected by very long waits. Whereas other countries with more concentrated outbreaks of Covid-19 may be able to redistribute patients and resources to help manage backlogs and recover services more quickly, this is a greater challenge in England given how severely waiting times have been impacted across all regions.
Continued partnership with the independent sector will help expand elective capacity in some areas, but the reality of Covid-19 and its impact on waiting times makes it unavoidable that clinicians will have to make difficult decisions about how to prioritise care for the foreseeable future.