What’s next for the NHS?

Building the resilience of the health and care system

Press release – embargoed to 0001 Wednesday 17 February 2020

One in six could be on an NHS waitlist by April

• Waitlists in England to hit 10 million by April
• 52 week waits up 12,008% by April since March 2020
• 6 million fewer referrals to treatment in 2020 as NHS became National COVID Service
• 1,660 extra lung cancer deaths alone due to delays

Despite the heroic efforts of healthcare leaders and frontline workers, a lack of system resilience forced the NHS to become a National COVID Service, a report says.

New modelling projects that waiting lists could hit 10 million by April, equivalent to one in six in England, according to new research by independent think tank Reform and Edge Health.

By April, the number of people waiting a year or more for care is expected to have risen 12,008% since the start of the pandemic in March 2020 – by December, the latest month for which there is data, it had already risen by 7,139%.

5,948,000 fewer referrals to treatment were made in 2020 compared to 2019 as the pandemic took hold.

The modelling projects that waiting lists could hit 10 million by April, equivalent to one in six in England, as referrals for non-COVID begin to restart whilst pandemic pressure and infection prevention measures still limit NHS capacity. This is a conservative estimate as data for December and January, when routine care was again cancelled, is not yet available.

Tragically, for lung cancer alone 1,660 premature deaths are expected due to delayed diagnosis and treatment, the paper predicts.

George Batchelor, Director, Edge Health, said:

“The ferocity of the pandemic was met with tremendous bravery but came at a cost to normal NHS services, which in many areas were struggling before the pandemic. The full scale of this cost has not yet been seen, but the backlog is already ballooning and will get much worse in coming months.

“The short-term recovery of NHS staff will jar with the need to manage the backlog. But perhaps a bigger challenge will be how to balance the recovery while also building greater long-term resilience and preparedness for the future.”

ENDS

For more information or to arrange an interview with George  please contact us on info@edgehealth.co.uk or 020 8133 4504.

Notes to editors

1. Reform is an independent, non-party, charitable think tank whose mission is to set out ideas that will improve public services for all and deliver value for money.

2. Edge Health is a specialist firm that provides tailored health data analytics and insights to organisations.

3. Download the full report here.

4. ‘What’s next for the NHS’ is authored by Eleonora Harwich, Matthew Fetzer, Sebastian Rees, George Batchelor, Jennifer Connolly and Maria Starovoitova.

5. “New modelling projects that waiting lists for care could hit 10 million by April 2021” – see Figure 5 on page 14. Headline line number is calculated by dividing worse-case scenario waitlist projection by population size. Further details:

· The projections are based on the proportion of ‘missing’ activity that returns over the next few months and assuming lower NHS productivity due to infection control measures. This missing activity corresponds to the difference between the number of referral in 2019 and those in 2020. There were 5,948,000 fewer referrals in 2020 than in 2019.

· The projections assume that there is a gradual return to normal levels of referrals by GPs by March 2021 and assumes gradual return to normal treatment volumes considering COVID-19 safety measures by March 2021.

· Under the worst-case scenario, the official NHS waiting list grows to over 10 million by April 2021.

6. “By April, the number of people waiting a year or more for care is expected to have risen 12,008% since the start of the pandemic in March 2020 – by December, the latest month for which there is data, it had already risen by 7,139%” – please see Figure 3 on Page 13. A linear model was fitted to data from March 2020 until December 2020 describing the following relationship y = x + x^2 with x being the number of people waiting 52 weeks on the waiting list in a given month. The model perfectly described the rate of increase in the 52-weeks + waiting list category and was therefore projected forward until April 2021 to find the number of people who would be waiting for more 52 weeks or more by April 2021.

7. “5,948,000 fewer referrals to treatment .” – see Figure 4 on page 13.

8. “1,660 extra lung cancer deaths” – see Appendix on page 36 – 37 for methodology

9. “The findings come as NHS officials last week warned that extended waits for treatment can be expected “for some years”.” – see NHS Confederation letter here.

10. “Modelling identified that around 141,808 worth of hospital ‘bed-days could have been freed up during the April 2020 peak, had delayed discharges and hospital overstays been avoided.” – see Figure 10 on page 27.

11. “Calls made by NHS Confederation to increase bed capacity in acute services would not be the correct response” – response to NHS Confederation letter here. Refers to the first bullet point on page 3 which lists a number of recommendations to tackle the impact of the pandemic on the NHS, including additional investment in acute services to increase bed capacity.

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Published 17 February 2021