Nuffield Trust: Health services can’t work fast enough against built-up demand following Covid-19 shutdown

John Appleby responds to the latest NHS combined performance figures from NHS England and NHS Improvement.

Press release

Published: 10/09/2020

Responding to the NHS combined performance figures from NHS England and NHS Improvement, Nuffield Trust director of research and chief economist John Appleby said:

“Despite the efforts of NHS staff, health services cannot work at the speed they need to in order to work through the still unknown built-up demand caused by the shutdown of services.

“These figures show us that activity in some parts of the service, including cardiovascular diagnostics, are growing sharply, and that more people are coming forward for care, but we still have much further to go to reach levels seen before the pandemic.

“More people are being referred for care than leaving the health system; this leaves more people waiting longer for planned treatment or operations. It is concerning to see that over half of people now waiting for care have waited over 18 weeks. The truth is that the NHS is now weighed down by the necessary Covid measures put in place to protect it. 

“Expectations for recovery may need to be reset as the NHS continues to grapple with the aftermath of this shutdown. The public may have to accept that access to care is going to become more difficult for some time.

“With Covid-19 cases appearing to be on the rise again, there is a very real risk we are a few weeks away from an upturn in hospital admissions as a result of the virus, just as the system will be battening down for additional winter pressure alongside efforts to recover. All of this points to one of the most difficult winters the NHS will face.”

Notes to editors

  • The latest monthly combined performance figures from NHS England can be found at:
  • The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  • For more information or to arrange an interview, please contact Simon Keen on 07780 475 571 or