Queues for routine operations are expected to peak in 2024 at around 10.7million in the most pessimistic scenario, modelling from the NHS shows. It is because the health service expects many patients who missed operations to now come forward for care
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One in five people in England will be stuck on NHS waiting lists by 2024, leaked modelling submitted to ministers shows.

Queues for routine operations are already at record highs with more than 6million people waiting for procedures now, compared to 4.4m pre-pandemic. 

But official health service forecasts project this could rise to 10.7m under the most pessimistic scenario — about two-and-a-half times the number before Covid.

And even in the most optimistic scenario it could still hit 9.2m come March 2024.

There are around 10m ‘missing’ NHS appointments in England from the pandemic, and health chiefs are uncertain how many of these will come forward in the coming years.

And despite the Government’s promise to end one year waits by 2025, the modelling predicts there could still be up to 200,000 waiting that long by that time. In the most optimistic scenario they said there could be 75,000 still waiting.

The forecasts, seen by the Spectator, are thought to have been circulated ahead of yesterday’s publication of the long-awaited NHS backlog recovery plan. 

It also found waiting lists will only begin to start dropping by 2025, and fall gradually by between 400,000 and 700,000 a year. At that rate it would take 27 years to clear the excess backlog that has amassed during the pandemic. 

Queues for routine operations are expected to peak in 2024 at around 10.7million in the most pessimistic scenario, modelling from the NHS shows. It is because the health service expects many patients who missed operations to now come forward for care

Queues for routine operations are expected to peak in 2024 at around 10.7million in the most pessimistic scenario, modelling from the NHS shows. It is because the health service expects many patients who missed operations to now come forward for care

Other estimates showed up to 200,000 people could still be on waiting lists for more than a year by 2025 under the most pessimistic scenario. This was despite Health Secretary Sajid Javid saying year-long waits would end by this date

Other estimates showed up to 200,000 people could still be on waiting lists for more than a year by 2025 under the most pessimistic scenario. This was despite Health Secretary Sajid Javid saying year-long waits would end by this date 

Edward Argar this morning blamed people who did not seek NHS care during the Covid crisis for fuelling the waiting list, which has left one in nine people in England waiting for treatment or tests

Edward Argar this morning blamed people who did not seek NHS care during the Covid crisis for fuelling the waiting list, which has left one in nine people in England waiting for treatment or tests

 

NHS sources said the waiting list was expected to get worse over the next few years as more patients who had missed appointments came forward.

They added that it was impossible to predict the number of missing patients that were set to come forward.

Ministers have hiked national insurance contributions to bring in an extra £12billion to help battle through the backlog.

WHAT’S IN THE RECOVERY PLAN? 

  • END TWO YEAR WAITS BY JULY 2022
  • END 18-MONTH WAITS BY APRIL 2023
  • END 65-WEEK WAITS BY MARCH 2024
  • END ONE YEAR WAITS BY MARCH 2025
  • 9MILLION MORE CHECKS AND TESTS BY MARCH 2025
  • ELECTIVE CARE WAITING LISTS TO COME DOWN FROM MARCH 2024
  • 75% OF URGENT CANCER REFERRALS DIAGNOSED OR RULED OUT WITHIN 28 DAYS BY MARCH 2024
  • NUMBER OF PEOPLE WAITING MORE THAN 62 DAYS FOR URGENT CANCER REFERRAL BACK TO PRE-PANDEMIC BY MARCH 2023
  • 95% OF PEOPLE RECEIVE DIAGNOSTIC TEST WITHIN SIX WEEKS BY MARCH 2025
  • 30% MORE ELECTIVE CARE BY 2024/25 THAN BEFORE THE PANDEMIC

* ALL TARGETS DEPEND ON MAINTAINING ‘LOW LEVELS OF COVID’

HOW WILL THE TARGETS BE ACHIEVED?

  • AT LEAST 100 COMMUNITY DIAGNOSTIC CENTRES OVER THE NEXT THREE YEARS
  • NEW SURGICAL HUBS ADDED TO CURRENT NETWORK OF 122
  • OFFER PATIENTS ALTERNATIVE LOCATIONS FOR TREATMENT WITH SHORTER WAITING TIMES
  • TEAM OF SPECIALISTS TO HELP PATIENTS PREPARE FOR OPERATIONS
  • CONDUCT MORE TESTS AT SAME TIME
  • GROUPS OF CLINICIANS TO GIVE INSTANT ACCESS TO TEST RESULTS
  • SEPARATE ELECTIVE AND URGENT CARE TO ENSURE ‘RESILIENCE’ OF ELECTIVE CARE DELIVERY
  • ‘STRENGTHENED RELATIONSHIP’ WITH PRIVATE SECTOR TO SPEED UP RECOVERY
  • REFORMING OUTPATIENT APPOINTMENTS
  • ONLINE PLATFORM FOR PEOPLE IN QUEUE TO GO LIVE THIS MONTH
  • NHS TO ANALYSE WAITING LIST DATA BASED ON AGE, DEPRIVATION AND ETHNICITY TO TACKLE DISPARITIES

Around the time of the announcement, modelling by the Department of Health forecast waiting lists would be around 5.5million by 2025.

But the arrival of the Omicron variant and the subsequent shift of the health service onto a ‘war footing’ to dish out a million boosters a day has seen projections for the waiting list accelerate.

The bleak projections come after the backlog-clearing plan faced criticism across both sides of the house for not being ambitious enough.

Announced yesterday, the Government’s blueprint promises to scrap year-long waits by 2025, while some cancer targets won’t be met until at least 2024.

But Tory backbenchers criticised the plans for lacking ambition. Former chief whip Mark Harper suggested that families would have expected better results from April’s £12billion tax grab.

Ministers were today forced to defend the Government over accusations it had ‘terrified’ people away from the health service during the pandemic. 

When grilled on whether the Government’s advice to avoid the NHS was to blame for spiralling waiting lists, health minister Edward Argar said the measures ‘had to be put in place’ to ensure medics could deal with Covid.

Studies have shown that the Government’s ‘stay at home, protect the NHS, save lives’ messaging was powerful and made people reluctant to use the health service. 

Asked on talkRADIO how the NHS backlog spiralled out of control, Mr Argar said it was a combination of Covid measures introduced by the Government and the public’s own doing. 

He said: ‘So we’ve got a waiting list of 6million, that’s gone up from where it was before the pandemic by give or take around 2million.

‘That’s a reflection of the measures that were taken during the pandemic, in terms of hospitals not being able to perform as many normal procedures and people not coming forward for a variety of reasons. 

‘But there’s 8.5million people we estimate who normally would have come forward who haven’t.

‘Now they won’t all necessarily come forward, but we’ve got to plan for that, which is why in this plan we set out yesterday, we set out what we think is an ambitious but realistic trajectory to start bringing those waiting lists down and help people get the treatment they need to tackle both pain and anxiety they will be feeling if they’re waiting for a diagnostic test.’

Host Julia Hartley-Brewer said people stayed away from the health service because they were ‘terrified out of their minds by adverts that told them the plague is going to kill them if they step out of their home’ and that their job was to protect the NHS. 

Asked whether the Government should take responsibility for telling people to stay away from the health service, Mr Argar said: ‘I think the NHS was under huge pressure in that first wave and later on in the year. 

‘There are a number of measures that had to be put in place. Firstly, there had to be capacity in the NHS for clinicians to treat those with the most urgent illness.

‘And when someone was admitted to hospital with Covid, they were very seriously ill so there had to be the capacity to treat those people who came in in that emergency situation, which meant some electives, a large number of electives had to be postponed as a result of that.’ 

Top doctors warned that the stay at home message discouraged patients from turning to GPs over health concerns.

And studies have shown it deterred thousands from attending hospitals with life-threatening symptoms and may have contributed to a surge in heart attack deaths. 

The above graph shows how the NHS waiting list could grow up to 2025. The National Audit Office warns if 50 per cent of missing patients return and demand grows at 3.2 per cent a year then the list could surge above 12million. But should the NHS manage to increase treatments dished out by more than 10 per cent a year then the list should stabilise at 8million in 2024 before falling slightly, they suggested

The above graph shows how the NHS waiting list could grow up to 2025. The National Audit Office warns if 50 per cent of missing patients return and demand grows at 3.2 per cent a year then the list could surge above 12million. But should the NHS manage to increase treatments dished out by more than 10 per cent a year then the list should stabilise at 8million in 2024 before falling slightly, they suggested

The NHS recovery plan was due to be published on Monday but it was pushed back at the 11th hour because of a row over 'tough targets' demanded by the Chancellor Rishi Sunak (pictured today), sources say

The Prime Minister had hoped to announce the plan yesterday

The NHS recovery plan was due to be published on Monday but it was pushed back at the 11th hour because of a row over ‘tough targets’ demanded by the Chancellor Rishi Sunak (pictured left, today) and the Prime Minister (right, also today)

Data-sharing care plan to stop elderly being ‘bounced around’ 

Hospitals will share patient data with local councils under new reforms to stop patients being ‘bounced around’ between the NHS and social care.

Every patient will be given a single ‘digital care record’ that can be accessed by pharmacists, carers and hospital staff under plans unveiled last night.

The Prime Minister said it is vital to ‘join up’ the health service with social care systems to ‘ensure no patient falls through the gap’.

A new White Paper on Integration set out proposals aimed at tackling the disconnect between hospitals and community care systems, which has a particularly damaging impact on older and vulnerable patients.

Under wide-ranging changes, the NHS will share patient data with local authorities so they each have a single record which is available to carers in the community as well as nurses and doctors at hospitals.

This will replace the current situation where those with complex care needs often ‘find themselves having to navigate complex and disjointed systems’.

For example, currently a patient with dementia may receive an at-home carer funded by the local authority but this carer will not be given access to the patient’s medical records from a recent hospital stay.

The digital care record will allow patients to ‘book appointments, order prescriptions, and communicate with their care providers on one platform’, rather than communicating with several different organisations.

People will no longer have to remember key facts such as dates of diagnosis or medicines prescribed, taking pressure off patients to coordinate their own care.

The White Paper also aims to tackle the problem of delayed discharges from hospital, which has knock-on effects on the whole NHS system and is hampering attempts to tackle the elective care backlog. 

Unveiling the Government’s long-awaited Elective Recovery Plan for tackling the backlog yesterday, Mr Javid warned that waiting lists could soar to 14million without action. 

But he said that even with the new plan, the number waiting for care would ‘keep rising before it falls’.

He said: ‘A lot of people understandably stayed away from the NHS during the heights of the pandemic, and the most up-to-date estimate from the NHS is that that number is around 10 million people. 

‘Assuming half of the missing demand from the pandemic returns over the next three years, the NHS expect waiting lists to be reducing by March 2024.’

The NHS plan includes measures such as sending patients across the country for surgery, covering the cost of their accommodation and transport, if their local hospital is too busy.

New ‘surgical hubs’ – where surgeons perform the same procedure all day – will also be established to ‘fast-track’ operations. More private hospitals will also be used for NHS operations.

And 100 ‘one-stop-shop’ diagnostic centres will be established in venues including shopping centres to clear the enormous backlog of tests including CT and MRI scans. The NHS will also deliver around 30 per cent more elective activity by 2024 than before the pandemic.

The publication of the plan was delayed over the weekend after the Treasury demanded tougher targets to deliver value for money for taxpayers.

An extra £36billion is being pumped into health and social care over the next three years though an unprecedented national insurance hike of 1.25 per cent.

But the Treasury lost the battle for a more ambitious plan, and instead some existing targets have been watered down.

A target of eliminating the number of patients waiting for two years has been pushed back from March this year to July. And on cancer care, the NHS have been given until March 2023 to return the proportion starting treatment within two-months back to pre-pandemic levels.

Last night, critics said the plan ‘fell well short’ of what was needed, noting it did not include a workforce plan to address chronic staffing shortages.

They also warned it does not address the crisis in social care that means medically fit patients are clogging up hospital beds due to there being no community care available.

One Whitehall source said that targets agreed with health chiefs last year had been watered down, with some initiatives, such as a greater focus on payment by result for elective operations, dropped from the plan altogether.

‘It feels like Government by the NHS for the NHS,’ they added. ‘We take the pain of raising the money for them and we end up with a plan that is much more pessimistic than we thought we had agreed.’

Conservative former chief whip Mark Harper said parts of the plan are not ‘ambitious enough’. 

He added: ‘Many on this side of the House were very reluctant but did support the increase in resources for the NHS through the increase to National Insurance and then the health and social care levy, but when we are making that argument to our constituents they will expect that money to deliver results.

‘I think only getting to 99 per cent of patients waiting less than a year by March 2024 isn’t ambitious enough.’ 

Health think tanks and medical organisations expressed concerns the waiting lists will continue to spiral beyond 2024 because there are simply not enough staff to deliver care.

Shadow Health Secretary Wes Streeting said: ‘The single biggest challenge facing the NHS is the workforce challenge. There are 93,000 staffing vacancies in the NHS today.

‘We know the NHS want a workforce plan, the public want a workforce plan and he promised a workforce plan. So where is it?’

He said the plan ‘falls seriously short of the scale of the challenge facing the NHS and the misery that is affecting millions of people stuck on record high NHS waiting lists’.

Richard Murray, chief executive of The King’s Fund think tank, welcomed the initiatives in the plan but said it could not be achieved without more staff.

He said: ‘Without enough clinical staff these targets will remain aspirational numbers in a plan rather than real change for patients.

‘For many years the NHS has been hamstrung by chronic staff shortages, and today’s plan is a long way short of providing a comprehensive solution.’

Saffron Cordery, deputy chief executive of NHS Providers which represents hospitals, said: ‘We need to have the staff in place to achieve all of these ambitions.

‘Workforce shortages and the resulting unsustainable workloads on existing staff, are the biggest challenges facing trusts right now. We need urgent national action to tackle this.

‘And there can be no end to NHS delays without a sustainable workforce and funding solution for social care. This is not being addressed with anything like the urgency it demands.’ 

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