NHS England published a three-year plan in February to tackle the backlog of services after the Covid-19 pandemic has already seen long waiting lists rise to record levels. The Department of Health and Social Care is responsible for funding the recovery plan. But the cash initially allocated by ministers for the scheme has not kept pace with inflation and the NHS faces “significant” workforce and productivity issues, the National Audit Office (NAO) said. In addition, the watchdog warned that relying on overstretched doctors to absorb some of the work traditionally done in hospitals was likely to miss key targets, leaving desperate patients – some of whom have waited years for treatment – in the lurch. “Health leaders agree that the NHS’s ability to clear elective backlogs is under serious threat unless the government acts quickly,” said Matthew Taylor, chief executive of the NHS Confederation, which represents the health care system in England, on Wales and Northern Ireland. Dr Emma Runswick, deputy chair of the board of the British Medical Association, which represents around 150,000 doctors, said: “It is absolutely necessary to urgently review the funding the government has put in place to deal with delays and growing waiting lists from Covid- 19. It is right that this funding should rise in line with inflation, otherwise the recovery plan simply will not work.” NHS England’s plan predicted services would recover to pre-pandemic levels of activity in early 2022-23, with a target of around 30% more treatments by 2024-25. However, the NAO said that increasing activity to these levels would be a “historic feat”, adding that it would “require a rate of growth not seen recently”. The NHS is now operating at 96% of pre-pandemic levels. To help achieve its targets, NHS England wants GPs to handle many cases previously handled by hospital doctors, the NAO said. However, the watchdog said it was concerned that GPs were already under pressure, with the GP workforce having fallen by 4% between June 2017 and June 2022. The NAO also said that NHS England’s desire to limit follow-up appointments in hospitals had caused concern among some clinicians and managers. NHS England set a target of a minimum 25% reduction in outpatient follow-up appointments by March 2023, but the NAO said it had heard from doctors who “said incentives to reduce the number of follow-up appointments could lead to increased harm to patients at a time when more patients may need follow-up due to the magnitude of delays and the complexity of the conditions people are presenting with.” Archie Bland and Nimo Omer take you to the top stories and what they mean, free every weekday morning Privacy Notice: Newsletters may contain information about charities, online advertising and content sponsored by external parties. For more information, see our Privacy Policy. We use Google reCaptcha to protect our website and Google’s Privacy Policy and Terms of Service apply. The NAO said NHS England aimed to eliminate elective care waits of more than a year by March 2025 and that by March 2023 the number of patients waiting for cancer care more than 62 days after an urgent referral should to return to pre-pandemic levels. But the warden said people could face long waits even if progress is made. According to the NHS Constitution for England, 92% of patients on a waiting list should start treatment within 18 weeks of referral, but this target was met in just 61% of cases in August. Gareth Davies, head of the NAO, said: “There are significant risks to the delivery of the plan to reduce long waiting times for elective care and cancer care services by 2025. The NHS is facing workforce shortages and inflationary pressures and will need to be flexible to the response as the results of different initiatives in the recovery program emerge.” An NHS spokesman said: “Despite concerns about what is likely to be a very difficult winter, the NHS is currently on track to meet the next recovery milestones – having already effectively eliminated two-year waiting times for care and reducing waiting times 18 months by almost 60% in one year. “Staff have achieved this despite higher staff absences, more Covid patients in hospital this summer than the last two combined, reduced hospital capacity caused by social care issues discharging patients back into the community and increased demand for A&E services care”.
