Hospital waiting lists in England could peak at 8.1 million next summer, assuming demand for NHS care remains level and strikes by doctors continue, according to a new analysis.
The Health Foundation modelled four different scenarios that juggled different rates of elective care activity with the outcome of industrial disputes by healthcare workers.
One scenario, in which increased demand for NHS services remained at 7.8% a year and strikes stopped, could see waiting lists peak at around eight million in summer 2024 before falling to 7.8 million by the end of the year, the think tank predicted.
The elective care backlog in England has now reached 7.75 million – the highest number since records began in August 2007. This is despite Prime Minister Rishi Sunak making cutting waiting lists one of his five New Year pledges for 2023.
Impact of Strikes on the Elective Care Backlog
The Government has since blamed long-running strikes in the NHS for making this task more challenging. The Health Foundation report assessed that strikes by consultants and junior doctors have increased the waiting list by around 210,000. However, they were also adding costs and squeezing NHS finances.
Under one model, in which the current pay disputes came to an end and hospital activity growth increased by a third to 10.4%, waiting lists might subsequently be shown to have peaked in October 2023 and potentially fall to below 7.2 million by the end of 2024.
The roots of the growth in the elective care backlog lay in "avoidable failures including a decade of underinvestment in the NHS, a failure to address chronic staff shortages and the longstanding neglect of social care", the report said.
Saffron Cordery, deputy chief executive at NHS providers, said the report would "fuel trust leaders' concerns that the record-high waiting list will keep growing before it comes down". She said: "While strikes are not the leading cause of longer waits, the report confirms they exacerbate the issue by swallowing up NHS resources that could be better spent on cutting care backlogs. Productivity and efficiency in the NHS are also taking a massive hit as the strikes incur unplanned costs.
"Trust leaders are extremely worried that if this money is not reimbursed, the NHS will be forced to cut back on other vital services."
The British Medical Association (BMA) said the latest analysis showed that doctors were "not the ones to blame for the shameful backlog in NHS elective care". Professor Phil Banfield, BMA chair of council, said: "While there is no doubt that industrial action has had an effect on the ability to reduce waiting lists – something that could have been avoided entirely if the Government had come to the table willing to listen to doctors in the first place – it pales in comparison with a decade of failure of policy on the NHS from the top."
Addressing Staffing Issues and Boosting NHS Productivity
In its analysis, the Health Foundation cautioned that a new wave of COVID-19 or a bad flu season that intensified pressures on hospitals could skew its predictions for waiting lists over the next 2 years. A financial squeeze on NHS budgets that resulted in trusts reducing elective treatments to recover budget deficits could also have a substantial impact.
The Health Foundation called on the Government to address "significant staff shortages" and boost investment to improve NHS productivity. However, it warned, "there are no quick fixes and focus will need to be sustained over several years".
A Department of Health and Social Care spokesperson said, "Cutting waiting lists is one of the Government's top five priorities and we are taking action to shorten long waits, despite disruption from strikes."
"We have reduced 18-month waits by more than 90% since their peak in September 2021, and we have opened 127 community diagnostic centres across the country to offer quicker, more convenient checks outside of hospitals for conditions such as cancer and lung disease – with over five million additional tests so far delivered."
"We are maximising all available capacity by drawing on the independent sector, as set out by our Elective Recovery Taskforce, to give patients more control over where they receive their care so they can be treated more quickly."