Select Committee · Health and Social Care Committee

Clearing the backlog caused by the pandemic

Status: Closed Opened: 20 Jul 2021 Closed: 25 May 2022 24 recommendations 10 conclusions 1 report

The Committee has launched a new inquiry to quantify the level of pent-up demand for key healthcare services; and to consider whether fundamental changes to the organisation and delivery of NHS services will be required to manage the backlog of cases caused by the pandemic. MPs will examine levels of funding, capacity, organisation and leadership … Show more

Clear

Reports

1 report
Title HC No. Published Items Response
Ninth report - Clearing the backlog caused by the pandemic HC 599 6 Jan 2022 34 Responded

Recommendations & Conclusions

19 items
2 Conclusion Ninth report - Clearing the backlog cau… Accepted

It is not appropriate to set a numerical target for the proportion of appointments carried...

It is not appropriate to set a numerical target for the proportion of appointments carried out remotely in general practice. Instead practices should respond to the needs of their local populations and work together with patients to establish the most fitting medium for their consultations based on clinical outcomes. Remote … Read more

Government response AI summary
The government accepted the conclusion that setting numerical targets for remote general practice appointments is inappropriate, agreeing that practices should respond to local population needs.
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Department of Health and Social Care
3 Recommendation Ninth report - Clearing the backlog cau… Accepted

NHS England has already commissioned an evaluation of the role of digital tools in primary...

NHS England has already commissioned an evaluation of the role of digital tools in primary care. We recommend that it publishes that evaluation at the earliest opportunity and uses it as a basis to produce clear and consistent guidance on best practice in • Reducing bureaucracy and day-to-day IT administration … Read more

Government response AI summary
The government confirms NHS England's evaluation of digital tools in primary care has concluded, and it will publish clear guidance on best practice, including reducing bureaucracy and the use of remote consultations, in due course.
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Department of Health and Social Care
6 Recommendation Ninth report - Clearing the backlog cau… Accepted

We therefore recommend that NHS England completes and publishes evaluations of NHS 111 call first...

We therefore recommend that NHS England completes and publishes evaluations of NHS 111 call first services as soon as is practicable, including learning from those evaluations and the implications for any future iterations of the service.

Government response AI summary
The government states that NHS England is currently conducting detailed analysis of the NHS 111 First programme and expects the results to be published in 2023.
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Department of Health and Social Care
7 Recommendation Ninth report - Clearing the backlog cau… Accepted

The response to long covid shows both the kind of integrated, patient-centred care the NHS...

The response to long covid shows both the kind of integrated, patient-centred care the NHS can provide when systems work effectively, and the frustration and detriment experienced by patients who have to “fight” to access to the right care when systems do not work effectively. We heard that long covid … Read more

Government response AI summary
The government recognizes the importance of supporting long COVID sufferers, detailing existing investment of over £50 million in research and the establishment of over 90 specialist multidisciplinary clinics across the country to provide care.
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Department of Health and Social Care
9 Recommendation Ninth report - Clearing the backlog cau… Accepted

It is not acceptable for patients awaiting planned treatment or feeling the debilitating effects of...

It is not acceptable for patients awaiting planned treatment or feeling the debilitating effects of long covid to feel “abandoned” by the NHS. We appreciate the uncertainty about the length of future waiting lists, but this is no excuse for lack of communication—whether this be confirmation of a patient’s next … Read more

Government response AI summary
The government agrees on the importance of patient communication, stating NHS England has already published guidance for providers on effective communication and is actively working to improve waiting list management.
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Department of Health and Social Care
11 Recommendation Ninth report - Clearing the backlog cau… Accepted

Lastly, we heard that patient involvement in services was important to tackle long covid.

Lastly, we heard that patient involvement in services was important to tackle long covid. It should also be taking place in other areas. We have previously called for the Care Quality Commission’s assessments of Integrated Care Systems (ICSs) to include consultation with patient groups and patient outcomes, and we continue … Read more

Government response AI summary
The government accepts the principle of patient involvement, stating that the Care Quality Commission’s assessments of Integrated Care Systems already include consultation with patient groups and patient outcomes.
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Department of Health and Social Care
12 Recommendation Ninth report - Clearing the backlog cau… Accepted

We again recommend that the Care Quality Commission includes consultation with patient groups and details...

We again recommend that the Care Quality Commission includes consultation with patient groups and details of patient outcomes in its assessment of ICSs. (Paragraph 68) Funding and policies to tackle the backlog

Government response AI summary
The government agrees on the importance of patient involvement and states that the CQC's assessments of ICSs already include consultation with patient groups and patient outcomes.
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Department of Health and Social Care
13 Conclusion Ninth report - Clearing the backlog cau… Accepted

The pandemic has had a negative impact on health inequalities and highlighted the crucial importance...

The pandemic has had a negative impact on health inequalities and highlighted the crucial importance of effective public health services in supporting local populations. Public health services are therefore vital allies in tackling the backlog, and we are surprised at the decision merely to maintain current public health grant funding … Read more

Government response AI summary
The government acknowledges the importance of public health services and states that public health grant funding levels have been increased by £340 million in 2022/23 to £3.47 billion.
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Department of Health and Social Care
15 Conclusion Ninth report - Clearing the backlog cau… Accepted

We note that the Government decided to resist an amendment to the Health and Care...

We note that the Government decided to resist an amendment to the Health and Care Bill that would have required it to publish independently verified assessment of health, social care and public health workforce numbers at least once every two years, leaving a gap between its rhetoric about supporting frontline … Read more

Government response AI summary
The government acknowledges the importance of workforce assessments and states that it already publishes independently verified assessments of workforce numbers at least once every two years, and will continue this practice.
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Department of Health and Social Care
19 Recommendation Ninth report - Clearing the backlog cau… Accepted

We call on NHS England to demonstrate its ongoing commitment to staff wellbeing by publishing...

We call on NHS England to demonstrate its ongoing commitment to staff wellbeing by publishing a refreshed People Plan to cover the financial year 2022/23 as soon as is practicable.

Government response AI summary
The government states that NHS England is committed to staff wellbeing and will publish a refreshed People Plan for 2022/23 as soon as practicable, outlining support for wellbeing and addressing workforce shortages.
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Department of Health and Social Care
21 Recommendation Ninth report - Clearing the backlog cau… Accepted

As part of its broader health and care recovery plan, the Government must produce an...

As part of its broader health and care recovery plan, the Government must produce an independently-verified analysis of how many, and what type, of extra beds the NHS needs in order to provide safe and effective everyday care for patients, whilst also responding to need directly created by the pandemic. … Read more

Government response AI summary
The government accepted in principle, stating NHS England is working to produce an independently-verified analysis of the NHS's bed needs and will accompany this with sustainable, long-term plans to tackle delayed discharges.
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Department of Health and Social Care
23 Recommendation Ninth report - Clearing the backlog cau… Accepted

Ahead of the arrival of the new funding from the Spending Review in Spring 2022,...

Ahead of the arrival of the new funding from the Spending Review in Spring 2022, we recommend that Government provides more details on the 100 new community diagnostic hubs, including where they will be placed, who will staff them and how they will contribute to service improvement within and beyond … Read more

Government response AI summary
The government states that over 90 community diagnostic centres are now open, providing various services based on local need to support earlier diagnosis and treatment, making services more convenient and accessible.
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Department of Health and Social Care
24 Recommendation Ninth report - Clearing the backlog cau… Accepted

Access to care should not be dependent on where you live in the country.

Access to care should not be dependent on where you live in the country. Regional and national co-ordination will be necessary to ensure that strategies aimed at tackling the backlog do not have the unintended consequence of increasing health inequalities. Read more

Government response AI summary
The government states the Elective Recovery Taskforce is already working to adopt innovative solutions and foster collaboration across the country to ensure equitable access to care and prevent increased health inequalities from backlog strategies.
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Department of Health and Social Care
26 Conclusion Ninth report - Clearing the backlog cau… Accepted

We have heard much about how a robust social care system that can support hospital...

We have heard much about how a robust social care system that can support hospital discharges and free up capacity is essential to clear the backlog. We welcome the inclusion of the social care workforce in the refreshed Framework 15. Social care, however, did not receive an adequate settlement in … Read more

Government response AI summary
The government recognizes the importance of social care and commits up to £7.5 billion over the next two years, including £5.4 billion from the Health and Social Care Levy and £500 million for hospital discharge.
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Department of Health and Social Care
29 Conclusion Ninth report - Clearing the backlog cau… Accepted

There is enormous potential for technology to support a transformation in NHS care that will...

There is enormous potential for technology to support a transformation in NHS care that will bring benefits for patients and staff alike. However, this potential will not be realised while many providers still struggle with basic IT infrastructure. The Wade-Gery report calls for a roadmap for the delivery of its … Read more

Government response AI summary
The government commits to publishing a roadmap in response to the Wade-Gery report in Autumn 2022, detailing how data, digital, and technology will transform the NHS and support IT infrastructure improvements.
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Department of Health and Social Care
30 Recommendation Ninth report - Clearing the backlog cau… Accepted

NHS England must produce its roadmap in response to the Wade-Gery report on Putting data,...

NHS England must produce its roadmap in response to the Wade-Gery report on Putting data, digital and tech at the heart of transforming the NHS at the earliest opportunity so that we and others are able to scrutinise it ahead of implementation.

Government response AI summary
The government commits to publishing a roadmap in response to the Wade-Gery report in Autumn 2022, outlining how data, digital, and technology will transform the NHS and improve IT infrastructure.
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Department of Health and Social Care
31 Conclusion Ninth report - Clearing the backlog cau… Accepted

The upcoming national introduction of ICBs provides the opportunity for local integration and innovation.

The upcoming national introduction of ICBs provides the opportunity for local integration and innovation. This opportunity must not be wasted, particularly in the context of the backlog. There must be clear incentives for ICBs to deliver integrated and innovative care, with ICSs held accountable for the care they deliver. Read more

Government response AI summary
The government agrees on the importance of ICBs delivering integrated and innovative care with accountability, stating that the Health and Care Act 2022 places relevant duties on ICBs, and NHS England will publish guidance on ICB assessment to ensure incentives.
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Department of Health and Social Care
33 Recommendation Ninth report - Clearing the backlog cau… Accepted

We recommend the Government creates a platform to share examples of good practice and innovation...

We recommend the Government creates a platform to share examples of good practice and innovation at ICB level so that lessons can be learnt, and practices adapted in ways that reflect the health needs of local areas. Without this, the risk of regional inequalities in waiting lists and postcode lotteries … Read more

Government response AI summary
The government accepts the recommendation, stating NHS England is currently developing a platform to share good practice and innovation at ICB level, which is set to launch in Autumn 2022.
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Department of Health and Social Care
34 Recommendation Ninth report - Clearing the backlog cau… Accepted

We again recommend that a duty be placed on ICBs for them to have regard...

We again recommend that a duty be placed on ICBs for them to have regard to mental health and public health. (Paragraph 128) Clearing the backlog caused by the pandemic 39

Government response AI summary
The government agrees with the recommendation, noting that the Health and Care Act 2022 already places a duty on ICBs to reduce health inequalities and promote integration, which covers having regard to mental health and public health.
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Department of Health and Social Care

Oral evidence sessions

4 sessions
Date Witnesses
2 Nov 2021 Rt Hon Sajid Javid · Department of Health and Social Care View ↗
19 Oct 2021 Amanda Pritchard · NHS England, Ben Zaranko · Institute for Fiscal Studies, Professor Stephen Powis · NHS England, Sarah Lambrechts, Expert by experience, Siva Anandaciva · The Kings Fund View ↗
21 Sep 2021 Dr Adrian James · The Royal College of Psychiatrists, Dr Melissa Heightman · University College London Hospitals NHS Foundation Trust, Helen Lunt Davies, Expert by experience, Lere Fisher, Expert by experience, Ondine Sherwood · LongCovidSOS, Professor Martin Marshall CBE · Royal College of General Practitioners View ↗
7 Sep 2021 Anita Charlesworth · Health Foundation, Dr Andrew Goddard · Royal College of Physicians, Dr Katherine Henderson · Royal College of Emergency Medicine, James Wilkinson, expert by experience, Professor Neil Mortensen · Royal College of Surgeons of England, Shirley Cochrane, expert by experience View ↗

Who gave evidence

18 witnesses
WitnessOrganisationSessions
Amanda Pritchard · Chief Executive Officer NHS England 1
Anita Charlesworth · Senior Economic Adviser Health Foundation 1
Ben Zaranko · Research Economist Institute for Fiscal Studies 1
Dr Adrian James · President The Royal College of Psychiatrists 1
Dr Andrew Goddard · President Royal College of Physicians 1
Dr Katherine Henderson · President Royal College of Emergency Medicine 1
Dr Melissa Heightman · Clinical lead, Post-COVID assessment service University College London Hospitals NHS Foundation Trust 1
Helen Lunt Davies, Expert by experience 1
James Wilkinson, expert by experience 1
Lere Fisher, Expert by experience 1
Ondine Sherwood · Co-Founder LongCovidSOS 1
Professor Martin Marshall CBE · Chair Royal College of General Practitioners 1
Professor Neil Mortensen · President Royal College of Surgeons of England 1
Professor Stephen Powis · National Medical Director NHS England 1
Rt Hon Sajid Javid · Secretary of State Department of Health and Social Care 1
Sarah Lambrechts, Expert by experience 1
Shirley Cochrane, expert by experience 1
Siva Anandaciva · Director of Policy, Events and Partnerships The Kings Fund 1

Correspondence

2 letters
DateDirectionTitle
30 Nov 2021 To cttee Letter from the Secretary of State on CQC integrated care systems dated 12.11.21
19 Nov 2021 To cttee Letter from the Secretary of State on General Practitioners and PCR tests dated…