Almost £17bn needed to clear NHS backlog

The Health Foundation has estimated that it will cost up to £16.8 billion over the remainder of this Parliament to enable the NHS to clear the backlog of people waiting for routine elective care.

The foundation’s REAL Centre sets out the scale of the challenge facing government if it wants to clear the backlog in NHS care over the course of this parliament and return hospital waiting times to 18 weeks.  

The overall funding the NHS may need could yet be significantly higher than this as the REAL Centre’s modelling does not include the ongoing impact of coronavirus on NHS productivity, nor the additional investment that may be needed in primary and community services to support the recovery. They also warn that while major workforce shortages persist the NHS’ ability to clear the backlog, even with new funding, will be hampered.

There is already a record waiting list of 5.5 million people waiting for routine hospital treatment, of which 1.7 million have been waiting more than 18 weeks. The new analysis highlights two options facing the government – to clear the backlog over the course of this Parliament, which will present significant challenges in terms of boosting staffing levels and capacity, or address the waiting list over a longer eight year period.

On top of this, the number of ‘missing patients’ is now approaching an estimated eight million. As services resume, some of the missing patients are expected to present to the NHS needing care, although precise numbers are uncertain. If three quarters of the missing patients return and activity continues as usual, the waiting list could grow to 12.5 million.

The Health Foundation says that a total NHS funding increase of between £4 billion and £7.1 billion in 2022/23 alone, with further funding in subsequent years, would be needed to meet growing demands for care, return to pre-pandemic standards, tackle the growing backlog, meet rising demand for mental health and primary care services and cover ongoing costs of the vaccination programme.

Anita Charlesworth, the Health Foundation’s Director of Research and REAL Centre, said: “Covid-19 will cast a long shadow over the NHS for many years to come, even with a successful vaccination programme. The government will need to provide at least £13.3 billion to stop the long waiting list for NHS treatment growing even further over this parliament. Meeting the 18 week waiting times standard will require almost £17 billion of dedicated funding up to 2024/25. This is a huge challenge and it’s not just about money; it will require many more doctors and nurses to provide the care.    

“Long waits are not the only challenge facing the NHS. As the risks from Covid-19 continue the NHS needs to adapt to ensure it has enough capacity to treat outbreaks alongside the normal demands on the system. Enhanced infection control means the NHS can’t provide as much care as normal with the people and buildings it has. If heightened infection control measures are here to stay, the NHS will also need extra funding to fill the gap. Managing the costs of Covid-19 could be as much as tackling the waiting list backlog. The government must resist the temptation to pick and mix funding for Covid-19 and for the backlog – patients need both.”