NHS waiting lists are unlikely to fall in 2023, and the backlog is unlikely to be significantly tackled until mid-2024 despite being one of Rishi Sunak’s priorities for this year, research suggests.
The NHS has struggled to increase the number of people it is treating from its waiting lists each month due to ongoing pressures from Covid-19, although there have been signs of improvement in the past month, analysis from the Institute for Fiscal Studies (IFS) has found.
Max Warner, an IFS economist and one of the report’s authors, said that although the NHS had made “real progress” to reduce the number of patients waiting a very long time for care, efforts to increase overall treatment volumes had “so far been considerably less successful”.
He added: “To turn things around, and deliver on the headline ambition of increasing elective activity to 30% above pre-pandemic levels by 2024-25, would require unprecedented double-digit growth in treatment volumes over the next two years. That would be more than three times the growth rate in the five years prior to Covid, and looks increasingly unreachable. As a result, it is likely that the waiting list will flatline rather than fall over the coming year.”
The IFS examined progress against the NHS England plan for tackling waiting lists one year after its publication. In January, Sunak said “NHS waiting lists will fall and people will get the care they need more quickly” as one of his five key policy priorities for 2023.
The NHS Providers’ chief executive, Julian Hartley, urged the government to introduce a fully funded workforce plan and to talk to unions about pay for this financial year as strikes were causing huge disruption to services, and risked undoing hard-won progress made on care backlogs.
“Mounting pressures on acute, ambulance, mental health and community services, such as chronic workforce shortages, could hamper efforts to cut the backlog further if left unchecked,” he said.
He added it was “remarkable” that trust leaders and staff had made “significant progress … given the challenging circumstances”.
The IFS researchers praised the NHS’s overall strategy, noting that the health service had made “meaningful progress” in its efforts to reduce the number of patients waiting a very long time for treatment, with waits of two years more or less eliminated, and that it is “within reach” to eliminate waits of 18 months or more by April.
But they warned that less progress has been made in increasing elective care to about 30% above pre-pandemic levels by 2024-25 – a challenging target given this compares with average annual growth of 2.9% in the five years prior to the pandemic. It is also undermined by the fact that in the 10 months following the publication of the elective recovery plan, the NHS treated 5% fewer patients from the waiting list than over the same period in 2019.
The researchers think that given the continued pressures on the health service and the fact the population is becoming larger, older and sicker, it is unlikely that double-digit annual growth – about 10.3% – will be achieved over the next two years.
Assuming that the NHS would still manage to significantly increase treatment volumes, albeit than by less than the “truly remarkable” increase originally planned, the researchers concluded that the waiting list will flatline over 2023, and to only begin falling “meaningfully” from mid-2024.
Meanwhile, NHS England announced that an estimated 780,000 additional surgeries and outpatient appointments would be provided at 37 new surgical hubs, 10 expanded hubs and 81 new theatres, in what it said formed part of the “biggest and most ambitious catch-up plan in NHS history”. There will also be 584 new beds specifically for elective care and nearly 90 more critical care beds across the country.
A Department of Health and Social Care spokesperson said £14.1bn in additional funding had been pledged over the next two years, adding: “The NHS has virtually eliminated waits of more than two years for treatment and has cut 18 month waits by over 50% in a year.”
