NHS waiting list in England could soar to 14 million as staffing and pay issues persist

The NHS waiting list in England could rise to 14 million by autumn 2022 and keep increasing, a new report warns.

Millions of patients didn’t receive care during the coronavirus (Covid-19) pandemic due to overwhelmed health services. If they return for medical attention, then the number joining the waiting list could outstrip the number being treated. That’s according to a new report by the Institute for Fiscal Studies (IFS).

Staff shortages and 3% pay rise

In July, health secretary Sajid Javid warned that NHS waiting lists in England could rocket to 13 million.

In an interview with the Sunday Telegraph a few weeks after being appointed to the role, Javid said what had “shocked me the most” was “when I was told that the waiting list is going to get a lot worse before it gets better”.

However, Javid still pushed ahead with ‘Freedom Day’ on 19 July, ending all coronavirus restrictions. According to latest government figures, 747 coronavirus patients were admitted to hospitals in England on 3 August.

The Royal College of Nursing’s England Director Patricia Marquis said the IFS figures “confirm the immense task that lies ahead for health and care services in recovering from the pandemic”.

Adequate staffing levels and fair pay are key to increasing NHS capacity. Marquis said:

If the Health Secretary wants to address the looming waiting list crisis, he should start by investing in the workforce.

A significant pay rise will demonstrate value and help retain experienced nursing staff whom health services can’t afford to lose with this challenge ahead.

Missing patients

The IFS warned:

In our first scenario, 80% of the approximately seven million ‘missing’ patients return over the next year, the NHS operates at 90% of its 2019 capacity this year and next…

Under this scenario, waiting lists would soar to 14 million by the autumn of 2022 and then continue to climb, as the number joining the waiting list exceeds the number being treated.

The IFS said it’s unlikely all patients will return due to the fact some will have died and others might have had private treatment or chosen to live with their health issues. But most will require treatment at some point, especially as virus cases decrease and “people are more willing to seek healthcare”.

Even under the most optimistic scenario, the number of people waiting for treatment would rise to over nine million in 2022. And it would only return to pre-pandemic levels in 2025.

The organisation said this outcome would require NHS capacity to increase by 5% this year and next, compared with 2019, and then by 10% in 2023 and beyond.

It said this would be the equivalent of treating about 1.6 million extra patients a year.

The report states:

Our scenarios show that, in the longer run, whether or not waiting lists remain high will ultimately be determined by what capacity the NHS can achieve in the coming years.

Shortly after her announcement as the new chief executive of NHS England, Amanda Pritchard acknowledged that among the pressures faced by the health service is “focusing on tackling the waiting times that have inevitably built up over the Covid pandemic”.

‘A wake-up call’

Max Warner, a research economist at the IFS and an author of the analysis, said:

More than four million people were on an NHS waiting list even before the pandemic.

Covid-19 has only made matters worse, as millions of people have missed out on treatment and millions more haven’t even been referred onto the waiting list to begin with.

He said without boosting NHS capacity there’s “a real risk… much longer waiting lists will be with us for years to come”.

Labour’s shadow health secretary Jonathan Ashworth said:

This analysis should be a wake-up call for ministers.

It’s unacceptable that so many patients are waiting longer in pain and distress for vital treatment including cancer care. Hundreds of thousands are waiting over a year for operations and some are even waiting over two years risking their long-term health.

Years of underfunding and cuts to healthcare had already left our NHS with ballooning waiting lists before the pandemic hit. Given these warnings it’s now even more urgent that a long term rescue plan is put in place to give the NHS the resources and staff it needs to bring down waiting lists and reducing waiting times for treatment.