Approximately one year ago today, life in the UK ground to a screeching halt in a way that many of us could never have imagined.

 

March 2020 saw the United Kingdom plunged into lockdown to help curb the spread of the Covid-19 virus. While a year later, we now have one of the world’s most successful vaccination programmes, and we do finally look set to have the virus under control, we are certainly not out of the woods yet, and we can’t afford to take our foot off the gas just yet.

On top of the Coronavirus pandemic, which has claimed the lives of more than 130,000 people in the UK over the last year, health experts and officials are concerned that the death toll may rise further, not due to Covid-19, but rather due to the waiting lists of the NHS due to the pandemic.

Do experts have real cause for concern about these waiting lists, and if so, what can be done to set things right as “normality” slowly returns?

Backlogs causing real concern

In the early spring of 2020, national lockdown restrictions were imposed on the UK, stating that we were only permitted to leave the home for essential purposes and that, unless you were classed as a ‘key worker’, you were told to stay home and work from home whenever possible.

To help ease the burden on the NHS and to prevent hospitals from becoming overwhelmed, people were told to avoid visiting the hospital unless it was absolutely necessary, and appointments, treatments, and surgeries were postponed and pushed back.

Statistics recently revealed, however, point to the fact that backlogs for non-Covid care are much worse than first anticipated and that there are at least 4.52 million people currently waiting for care and treatment. Of the 4.52 million people on the waiting list in England, approximately 224,000 had been waiting over a year for their treatment, compared to around 1,500 people at the end of 2019.¹

There are currently more than 4 million fewer hospital referrals than the same time in 2020, with many of them either seeking care from their local GP in the community or simply not receiving care or treatment at all. Because of this, experts are concerned that once restrictions are lifted, the NHS may again find itself overwhelmed, this time by simply trying to work through the backlog of people on waiting lists.

A timeline of waiting lists

The start of the pandemic…

In the months of April and May 2020, A&E demands dropped sharply, which was actually beneficial in terms of waiting times for free beds and trolleys.

Experts believe that the main factors for this drop were:

• Reduction in road traffic (fewer vehicles on the roads so fewer accidents)
• Reduction in alcohol-related injuries due to pubs and nightclubs being closed
• People simply staying home and treating minor injuries themselves

The last factor is concerning as experts were worried, people may deliberately have been staying home and avoiding the hospital when, in fact, they did require medical treatment.

Summer of 2020

In June and July, lockdown restrictions were eased in the UK, and NHS demand once again started to increase to pre-Covid levels.

This carried on up until September, and once again, trolley waits increased, and the already under-staffed NHS struggled to meet time targets. This again highlighted the difficulties the NHS faces and raised real cause for concern that once the lockdown restrictions of 2021 are lifted, the NHS will again find itself overwhelmed.

Winter 2020/2021

Hospital admissions spiked in December 2020 but began to decline into the new year and were actually lower than they were in 2019.

However, waiting lists have increased and compared with this time last year, and they are significantly higher.

A reduction in cancer waiting time performance

Over the summer, the NHS did an exceptional job of improving cancer waiting time targets, yet over the winter, as Covid-19 cases peaked and lockdowns were imposed, progress slowed which meant that people in need of potentially life-saving treatments, medications, and procedures, were forced to wait longer than expected.

Now, somewhat positively, the number of cancer-related appointments and treatments is actually lower than it was before the pandemic. The bad news is that the number of cancer patients being seen quickly is also lower than what would be expected. This means that cancer care and treatments have been disrupted, which means lives will be at risk.

Looking to the future

So, what’s next for the NHS and NHS waiting lists?

Well, assuming that the vaccination program continues to roll out so successfully, and assuming that lockdown continues to be a success, NHS staff will likely find themselves able to concentrate on non-Covid treatments, appointments, and procedures.

The flexible workforce landscape has a significant role to play to support the NHS in tackling this backlog of patients. Along with potential innovative initiatives such as changes to GP appointments, virtual consultations- with the introduction of technologies, increase capacity unlike ever seen before,  reform with new ideologies will be required to attack the backlog of waiting lists.

As a multi-framework appointed staffing solutions organisation, ProMedical has and will continue to support the NHS in staffing solutions across the UK. Our People first model sets people at the core of healthcare. A person-centred approach may be what’s needed to ‘fix’ the system, putting people’s wellbeing as a priority, putting people’s pay/reward as a priority, and putting people’s needs as a priority as healthcare workers. Put simply, an understanding of what healthcare workers need and deserve in order to continue in healthcare.

There must also be investment and development in effective partnerships with workforce organizations to address the short-mid-term workforce challenges.

A new briefing from the NHS was launched on March 7, this year, it sets out a framework that aims to build back elective care and address the backlog aggressively. This new Framework for Recovery is a step in the right direction and highlights a model of robust planning and new innovative practices to decrease the ever-increasing waiting lists that are piling up daily.

The main issue, however, is that as the NHS was already vastly understaffed, it may again be overwhelmed simply with dealing with everyday illnesses and injuries when some semblance of normality returns. Increasing human resources at graduate level, retaining international healthcare professionals, and retention of present staff are fundamentals in solving the staffing crisis.

Issues that decrease retention including understaffing, workload pressures and poor morale – these all need acute solutions if staff are to come into and stay working in the NHS. We need to look deeply at the staffing issue from attraction into healthcare as a career right up until retirement.

Providing solutions that are sustainable now will benefit us all in the future. Simply put, we need more doctors and nurses entering the professions, staying in the professions and coming from overseas for long periods of time to work in the professions. So, what will make them come and stay? Reward, justice, fair treatment, work-life balance, less stress at work, good representation on important issues, and support at managerial level can all play a pivotal role in addressing a long-term staffing problem.

With recent talk of nurses and NHS staff going on strike over the government’s insulting’ 1% pay increase, which equates to just £3.50 extra per week, the NHS will have a great deal of pressure to deal with. However, if staff are to be retained, wellbeing and reward are paramount requirements that need real recognition at government level.

 

With current staffing levels as that are and morale at an all-time low, dealing with these backlogs will certainly be tricky, to say the very least.

 

References

NHS Confederation at https://www.nhsconfed.org/news/2021/03/copy-of-warning-that-nhs-waiting-list-could-be-scratching-the-surface