NHS waiting lists will continue to grow for another two years in England, and in some scenarios could more than double to 14mn, despite a tax rise designed to plough an additional £30bn into the service.
The bleak assessment was contained in a long-awaited government-backed plan for the health service to tackle the backlog of care from the coronavirus pandemic.
The document, with a foreword by Amanda Pritchard, NHS England chief executive, reaffirmed the health service’s “ambitions” to deliver 30 per cent more treatment than before the crisis and deliver about 9mn more tests and checks by 2025. However, it lacked the detailed numerical targets for waiting-list reductions ministers had wanted.
It revealed that from July nobody should have to wait more than two years for treatment — a delay from an original March deadline. One-year waits will be eliminated by March 2025.
However, experts criticised the lack of any serious new measures to address the service’s crippling workforce shortages, warning aspirations to boost activity beyond pre-pandemic levels would be in jeopardy without them.
Richard Murray, chief executive of The King’s Fund, suggested without enough clinical staff, targets for increasing treatment levels “will remain aspirational numbers in a plan rather than real change for patients”. The government must move beyond repeating manifesto pledges and instead come forward with a fully funded workforce strategy, he said.
With many Conservative backbenchers calling on the government to drop its plan to increase national insurance contributions from April to provide more funding for health and social care, the news that queues for treatment will still be rising at the start of 2024, a possible general election year, will worry ministers.
The plan said that if about half the “missing demand” from the pandemic returned over the next three years “then we would expect the waiting list will be reducing by around March 2024”. If everyone who had missed care came forward, and with no further action to increase treatment above pre-pandemic rates, the waiting list could increase to 14mn patients, the NHS warned.
Presenting the plan in the Commons, Sajid Javid, health and social care secretary, admitted that waiting lists would continue to rise. He told MPs the number of people waiting for elective care in England now stood at 6mn, up from 4.4mn before the pandemic. “Sadly, this number will continue rising before it falls,” he said.
He also acknowledged staff shortages in the health service, highlighting the “recruitment and deployment of NHS reservists” and pledging the service would make “greater use of the independent sector”.
However, Wes Streeting, shadow health secretary, said there was “no plan to tackle the workforce crisis, no plan to deal with delayed discharges and no hope of eliminating waits of more than a year before the general election in 2024”.
Measures outlined in the plan include the rollout of more than 100 diagnostic centres designed to speed up investigations and diagnoses. A total of 66 will be in use across England by the end of March — 26 more than planned, the document said.
New surgical hubs, designed as “cold sites” that will not be disrupted by emergency cases, will also be added to the network of 122 already operating across the country.
The document points to a larger role for the independent sector, with “elective care boards” established to bring together local providers, including the independent sector, “to agree priorities and solve operational challenges”.
Plans to use technology to reduce the number of outpatient appointments are confirmed, with patients offered telephone or video consultations in place of in-person hospital appointments, and booking their own follow-up care “and working with GPs to avoid the need for an onward referral where possible”.
Those who have been waiting longest for treatment can also be treated in hospitals outside their home areas, with the plan promising “a comprehensive support package, including transport and accommodation where necessary”.