According to a new analysis in The Lancet, the NHS needs to treat at least 10% more non-urgent hospital cases every month if it hopes to successfully begin tackling the high backlog caused by the pandemic.
Korrespondenz: Auswirkungen der COVID-19-Pandemie auf die Wartezeiten des NHS England für elektive Krankenhausversorgung: eine Modellstudie. Bildnachweis: toodtuphoto / Shutterstock
From February 2020 to October 2022, the waiting list for non-urgent care grew by 2.6 million cases – an estimated 1.8 million more than if the pandemic had not struck.
Experts believe that the increase in cases will not be resolved until the end of 2025, even with a 30% increase in capacity compared to pre-pandemic levels outlined in the NHS England’s recovery plan.
During the early stages of the pandemic, the NHS was forced to postpone elective or non-urgent treatments to focus its resources on patients severely affected by Covid-19. This has led to a backlog of people waiting for treatment, many of whom require multiple referrals for different conditions.
To assess the extent of the disruption, researchers from the University of Edinburgh and the University of Strathclyde examined the number of referrals waiting for treatment in England each month from January 2012 to October 2022.
The waiting list increased from 2.4 million in January 2012 to 4.6 million at the start of the pandemic in February 2020, an increase of approximately 275,000 referrals per year. This steady increase suggests that the service was already gradually declining before the pandemic.
COVID-19 then exacerbated the decline, according to the researchers. By October 2022, over 7.2 million referrals were waiting for non-urgent treatment.
Experts warn that this is likely a significant underestimate of the backlog, as it is expected that a large number of people have not yet sought treatment after the pandemic.
According to the study, an estimated 10.2 million fewer referrals for elective care were made from the beginning of the pandemic until October 31, 2022.
How many of these missing patients will return for treatment is one of the biggest unknowns in predicting future waiting list numbers.
The research team simulated a range of scenarios based on the assumption that between 25 and 75% of the missing patients sought medical care. This allowed the scientists to model the outcome of several capacity increases based on waiting list numbers.
The results highlight the importance of resilience within the healthcare system to minimize the impact of future emergencies on the provision of routine care, researchers say.
Dr. Syed Ahmar Shah from the Usher Institute at the University of Edinburgh, who led the study, said: „The healthcare system was struggling to keep up with demand for many years before the pandemic, and the COVID-19 pandemic has only exacerbated the problem. Moving forward, it is clear that we cannot afford to overwhelm our healthcare systems; instead, we need to strengthen their resilience to better prepare for future emergencies.“
NOTE: Research letters published in the „Correspondence“ section provide research findings and are peer-reviewed by external experts. The letters published in the „Correspondence“ section reflect the views of the authors and not necessarily those of The Lancet journals.