‘Hidden backlog’ looms as NHS referrals drop

The Health Foundation has revealed that there were 4.7 million fewer people referred for routine hospital care between January and August 2020 compared to 2019.

The analysis, representing a potential hidden backlog of unmet care needs, is the latest warning about the health service’s ability to handle increased demand this winter. The report authors say that the drop in demand for routine, consultant-led treatment, which under the NHS Constitution should have a maximum waiting time of 18 weeks, is unlikely to be because need has simply disappeared.

Instead, they say, it is likely to be due to huge pent-up demand for treatment caused by the pandemic.

During the first eight months of 2020, 4.7 million fewer patients in England were referred for consultant-led, routine hospital care as compared to 2019, a reduction of 34 per cent. NHS and health policymakers will need to plan for this ‘hidden backlog’ of unmet need, alongside ensuring treatment for the 4.2 million people currently waiting for routine elective care. Of those waiting for elective care, 2.3 million (46.4 per cent) have already waited longer than the 18 week standard.

Tim Gardner, one of the report authors, said: “While the NHS is rightly focused on the urgent task of fighting Covid-19, there is meanwhile a rising tide of unmet need which will have a significant impact on people’s health if a sustainable solution is not found. The NHS made significant progress towards fully reopening services after the first peak of the pandemic, but there is still a potentially huge hidden backlog, as the health service is undertaking far fewer routine procedures compared to last year. While the NHS is working hard to address the backlog, radical interventions will nonetheless be needed to avoid prolonged delays for those currently waiting for things like hip, knee and cataract surgery, as well as those not yet on any waiting list.

“There is no silver bullet – addressing these issues will take time, money and determination. A range of options should be explored – including making greater use of the independent sector, greater use of remote consultations, and creating dedicated diagnostic hubs and elective care centres. If no action is taken, long waits could become the norm for millions of people.”