Understand the scale of the NHS backlog in your ICS/STP after the Covid-19 disruption 

Between March and July, Covid-19 reduced NHS capacity and saw demand for services plummet. With a second national lockdown underway and a new wave of Covid-19 cases, there is further disruption to normal NHS services. ​This will mean longer waiting lists and often longer waiting times.

This page provides our latest insights on the NHS backlog. This page also provides access to ICS/STP level reports. These are currently freely available on request and can be provided down to specialty level (except where there are data limitations). 

Get an up to date backlog report for your ICS or STP

Select reports for ICS/STP

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Key stats - September 2020

78 million 

Weeks waited by people on the official NHS waiting list

10 million

Estimated size of waiting list by April 2021


People waiting more than 52 weeks for their operation 

Latest insights

  • Before the Covid-19 crisis, around 4.5 million patients were waiting for treatment across NHS Trusts in England (Feb 2020).

  • On the 13th of March we published our initial assessment of the potential impact of Covid-19 on the NHS, which highlighted the substantial lack of critical care beds.

  • On the 17th of March, NHS England and NHS Improvement issued advice to Trusts. This included guidance on the postponement of all non-urgent elective operations from 15th April at the latest for a period of at least three months. 

  • Our initial modelling in April estimated that the waiting list would grow to around 7 million by 2021.

  • The crisis cased by Covid-19 has now largely passed and most hospitals are seeking to return to 'normal', although increased infection control measures (e.g. mandatory PPE and cleaning) has led to a substantial decline in surgical productivity (fewer operations per day) - around a 30% reduction. 

  • Our latest modelling based on data published in July 2020 shows that as of May 2020:

    • People on the official NHS waiting list had waited in excess of 78 million weeks.

    • A drop in demand and access to General Practice led to 5 million fewer new RTT referrals.

    • In 2020 to October, there have been 3.8 million fewer treatments and 16.8 million fewer outpatient consultations.

    • Over 140,000 people had waited longer than 52-weeks - an x81 increase in the number waiting in February.

    • The combination of a long waiting list pre-Covid-19, a reduction in activity during the Covid-19 crisis, a slow recovery in referrals for treatment, and a substantial drop in operating productivity means that waiting times will dramatically increase over the next few months.

    • If 100% of the "missing" activity returns, the waiting list will grow to over 10 million by April 2021 - this drops to 8.1 million if 50% of the backlog returns.

  • To date, there are no clear indications of how the NHS as a whole will manage the backlog.

  • Guidance from the Royal College of Surgeon's outlines prioritisation criteria for patient being referred for treatment, while essential in the short run this approach needs to be better understood in the longer term as it could amount to rationing.

  • Get up to date information for your STP or ICS here

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Managing the backlog - Prioritiser

Priorisiter is a software solution that prioritises your surgical waiting list based on Royal College of Surgeons guidance, reducing the administrative burden on clinicians and unlocking their time to focus on delivery — which is important as the NHS recovers from the disruption of Covid-19.