Source · Select Committees · Health and Social Care Committee
Recommendation 5
5
Paragraph: 64
During our session on 30 June 2020, Sir Simon Stevens told us that he “expects”...
Conclusion
During our session on 30 June 2020, Sir Simon Stevens told us that he “expects” waiting times for and referrals to core health services to “go up quite significantly over the second half of the year.” We also heard from Sir Simon, Amanda Pritchard and Professor Steve Powis of the importance of restoring core services for patients. It nevertheless remains unclear to us what practical steps the Government and NHSE/I are taking and are planning to take to reduce waiting times, meet the backlog of appointments and prepare the NHS for addressing pent-up demand. The absence of a public plan to address these issues may be contributing to the inability of local trusts to inform patients when they can expect to receive a long-awaited medical procedure. Nevertheless, we do also recognise the significant difficulty in planning ahead when the risk of a second spike remains unclear.
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64
Government Response
Not Addressed
HM Government
Not Addressed
For elective care, the official statistics show that waiting times have been impacted by the pandemic, from a combination of enhanced IPC measures, and patients choosing to defer their care. The pace of recovery of elective care since the first wave of Covid-19 inpatients means that the total number of people waiting over 18 weeks has fallen month on month since July. Total cancer treatments are now back at or above the levels seen in 2019. However, the number of people waiting over 52 weeks has been rising, which is why additional funding for elective catchup will focus in part on these waits. The waiting list in October 2020 was 4.5m, slightly lower than the same time last year. Through the ‘phase 3’ guidance issued at the end of July 2020, focus has been on increasing elective activity by accelerating the return of non-Covid health services to as near-normal levels as possible whilst also preparing for winter demand pressures. Hospitals are now carrying out more than a million routine appointments and operations per week, with around three times the levels of elective patients admitted to hospital than in April. The NHS has been working with Royal Colleges to ensure clinical processes to prioritise the waiting list according to clinical need and length of waiting time. Patients should be part of a shared decision-making discussion around their care. In responding to the pandemic, trusts have been working collaboratively to sustain access for patients, and this has been supported by the development of more “hub” working models to support elective recovery. This ‘‘Adopt & Adapt’’ approach uses the following key components: • Workforce: Prioritising workforce capacity to support challenged services, in much the same way that staff were deployed to critical care during Phase 1. • Best IPC Practices: including COVID-19/Non-COVID-19 pathways; self- isolation guidance; testing; PPE; cleaning and building guidelines relevant to the service in question. • Additional Capacity & Facilities: Opportunities to utilise NHS facilities by sharing waiting lists; independent sector capacity and identify temporary facilities. The £1bn allocated through the Spending Review for the 2021/22 financial year will support the NHS in tackling the elective backlog and support hospitals to cut long waits for treatment by carrying up to one million extra checks, scans and additional operations or procedures. Through its COVID-19 recovery and existing planning processes, DHSC and NHSE/I are currently working (with NHS organisations) to agree how this funding will be spent in order to achieve maximum value and ensure the clinical needs of patients are best met.