Recommendation 6

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. Primary care Impact of the pandemic Monthly appointment numbers continue to rise since April and overtook pre-Covid-19 peak in September and October. An estimated 282.5 million appointments were booked across all GP practices in England in the twelve months up to October 2020. The Department and NHSE/I continue to work with general practices to help them meet demand safely and reassure patients that they should seek care when they need it. Steps being taken include: • a new £150 million General Practice Covid Capacity Expansion Fund has been made available up until the end of March 2021. This will support seven priority goals including expanding GP capacity, supporting clinically extremely vulnerable patients, continuing to tackle the backlog of some routine appointments with a particular focus on learning disability health checks, and supporting the establishment of Oximetry@home. • helping general practice adapt at pace to offer more remote care so that patients could continue to access GP services safely, by deploying laptops and headsets for use in primary care and accelerating the roll out of online video consultation capability. • refocusing the Quality and Outcomes Framework to support local outbreak management. • NHSE/I launched the Health at Home campaign which includes information and videos for patients on how to access GP services, including how to have an