Select Committee · Public Accounts Committee

NHS Backlogs and waiting times

Status: Closed Opened: 21 Oct 2021 Closed: 27 May 2022 3 recommendations 20 conclusions 1 report

The NHS in England was running at close to maximum capacity before the COVID-19 pandemic. The pandemic has led to a sharp drop in routine NHS activity, resulting in more people waiting for treatment, and waiting for longer . The Committee will question the senior officials at DHSC and NHS England on the current position …

Reports

1 report
Title HC No. Published Items Response
Forty-Fourth Report - NHS backlogs and waiting times in Eng… HC 747 16 Mar 2022 23 Responded

Recommendations & Conclusions

23 items
2 Recommendation Forty-Fourth Report - NHS backlogs and …

At our evidence session the Department and NHSE&I appeared unwilling to make measurable commitments about...

At our evidence session the Department and NHSE&I appeared unwilling to make measurable commitments about what new funding for elective recovery would achieve in terms of additional NHS capacity and reduced patient waiting times. NHSE&I will receive an additional £8 billion for elective care recovery and £5.9 billion for capital …

Government response. 2.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2023 2.2 The government published the Elective Recovery Plan which set out the goals for tackling the elective care and cancer backlogs over the course of the next …
HM Treasury
3 Recommendation Forty-Fourth Report - NHS backlogs and …

The NHS will be less able to deal with backlogs if it does not address...

The NHS will be less able to deal with backlogs if it does not address longstanding workforce issues and ensure the existing workforce, including in urgent and emergency care and general practice, is well supported. NHSE&I believes it will be 2 or 3 years before there is a material increase …

Government response. 3.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2023 3.2 Ensuring that the NHS has a workforce in the right numbers and with the right skills to deliver service commitments to patients is crucial. The government …
HM Treasury
4 Conclusion Forty-Fourth Report - NHS backlogs and …

It will be very challenging for the NHS to focus sufficiently on the needs of...

It will be very challenging for the NHS to focus sufficiently on the needs of patients when it comes to dealing with backlogs, both patients already on waiting lists and those who have avoided seeking or been unable to obtain healthcare in the pandemic. NHSE&I is concerned about those people …

Government response. 4.1 The government agrees with the Committee’s recommendation. Target implementation date Spring 2023 4.2 Delivery of the Elective Recovery Plan, and the initiatives deployed to achieve it, will be closely monitored by both the department and NHSE&I. Please also refer …
HM Treasury
5 Conclusion Forty-Fourth Report - NHS backlogs and …

Waiting times for elective and cancer treatment are too dependent on where people live and...

Waiting times for elective and cancer treatment are too dependent on where people live and there is no national plan to address this postcode lottery. In September 2021, patients in the worst-performing geographic areas were more than twice as likely as patients in the best-performing areas to have been waiting …

Government response. The government agrees with the Committee’s recommendation. and the government has done extensive work to model a range of scenarios to better understand the levels of ‘bounce-back’ demand. Modelling estimates that there could be over 7 million patients who did …
HM Treasury
6 Recommendation Forty-Fourth Report - NHS backlogs and …

For the next few years it is likely that waiting time performance for cancer and...

For the next few years it is likely that waiting time performance for cancer and elective care will remain poor and the waiting list for elective care will continue to grow. The UK has low numbers of healthcare resources per person compared with similar countries and actions taken now to …

Government response. 6.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2023 6.2 The government has been clear that the overall NHS waiting list is likely to worsen prior to improvements and service recovery. 6.3 As set out in …
HM Treasury
1 Conclusion Forty-Fourth Report - NHS backlogs and …

On the basis of a report by the Comptroller and Auditor General, we took evidence...

On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department) and NHS England and NHS Improvement (NHSE&I) about the backlogs and waiting times for elective and cancer care in the NHS in England. We also …

HM Treasury
7 Conclusion Forty-Fourth Report - NHS backlogs and …

But plans are only one part of the explanation for deteriorating performance.

But plans are only one part of the explanation for deteriorating performance. This Committee’s June 2019 report NHS waiting times for elective and cancer treatment concluded that the Department had allowed NHS England to be selective about which standards it focused on, reducing accountability. We recommended that the Department and …

Government response. 1.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2023 1.2 The mandate to NHS England sets out the strategic goals that the government has set for NHS England in the year ahead. The 2022-23 mandate was …
HM Treasury
9 Conclusion Forty-Fourth Report - NHS backlogs and …

We sought reassurance that all additional funding would be well spent and asked for examples...

We sought reassurance that all additional funding would be well spent and asked for examples of the measurable improvements that we could reasonably expect to see. We heard generally from the Department that with the additional £8 billion recovery funding it wanted to restore activity to the highest level possible …

Government response. 2.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2023 2.2 The government published the Elective Recovery Plan which set out the goals for tackling the elective care and cancer backlogs over the course of the next …
HM Treasury
10 Conclusion Forty-Fourth Report - NHS backlogs and …

Between 2010 and 2019 the NHS saw an average annual growth in emergency admissions of...

Between 2010 and 2019 the NHS saw an average annual growth in emergency admissions of more than 3% and in urgent cancer referrals from GPs of more than 10%. Although there was relatively strong growth in the number of consultants (over 3% per year) during that period, there was almost …

HM Treasury
11 Conclusion Forty-Fourth Report - NHS backlogs and …

The very large numbers of people who have not presented for healthcare, or were not...

The very large numbers of people who have not presented for healthcare, or were not able to obtain it, during the pandemic, as well as those who have already been on waiting lists for long periods of time present a huge risk to primary and emergency care services. This is …

HM Treasury
12 Conclusion Forty-Fourth Report - NHS backlogs and …

The University of Manchester’s Voices of COVID-19 project has interviewed over 2,000 NHS staff to...

The University of Manchester’s Voices of COVID-19 project has interviewed over 2,000 NHS staff to provide a national collection of testimonies in partnership with the British Library. This evidence highlights the concerns of frontline NHS staff regarding the public dissatisfaction they face and the NHS’s lack of capacity to deal …

HM Treasury
14 Conclusion Forty-Fourth Report - NHS backlogs and …

The Department and NHSE&I are now managing a large, growing and diverse set of challenges...

The Department and NHSE&I are now managing a large, growing and diverse set of challenges to elective and cancer care on top of the ongoing pandemic. We asked how the Department and NHSE&I expected the accelerated and expanded vaccine booster programme, announced on 12 December 2021, to impact on elective …

HM Treasury
15 Conclusion Forty-Fourth Report - NHS backlogs and …

The number of missing referrals and the size of the waiting list make for a...

The number of missing referrals and the size of the waiting list make for a daunting situation when it comes to the needs of patients. Thinking about the recent changes to GPs’ workload to allow them to focus on booster vaccinations, we asked how members of the public could know …

HM Treasury
16 Conclusion Forty-Fourth Report - NHS backlogs and …

There are 6 million people on the waiting list for elective care.36 NHSE&I told us...

There are 6 million people on the waiting list for elective care.36 NHSE&I told us it intends to focus on those with the highest clinical need and priority, and especially in the immediate period, those who have waited the longest time. For long-waiters, NHSE&I stated that its plan for this …

HM Treasury
17 Conclusion Forty-Fourth Report - NHS backlogs and …

We asked about how patients other than the longest waiters and those with the highest...

We asked about how patients other than the longest waiters and those with the highest clinical priority would be supported while they waited. NHSE&I stated that GPs had a role in managing these patients and that it was also asking secondary care clinicians to ensure patients were clearly informed about …

HM Treasury
19 Conclusion Forty-Fourth Report - NHS backlogs and …

We asked NHSE&I to explain these disparities.

We asked NHSE&I to explain these disparities. It told us that the COVID-19 pandemic had had a differential effect across the country and that the differences reflected where the NHS had most diagnostic capacity and skilled workforce compared with where these resources were more stretched. It also said that the …

HM Treasury
21 Conclusion Forty-Fourth Report - NHS backlogs and …

Among comparable OECD countries the UK has relatively low numbers of hospital beds, nurses and...

Among comparable OECD countries the UK has relatively low numbers of hospital beds, nurses and doctors per 1,000 population and also carries out relatively low numbers of advanced diagnostic examinations.46 NHSE&I told us that it would take two to three years before there was a material increase in NHS capacity. …

HM Treasury
23 Conclusion Forty-Fourth Report - NHS backlogs and …

NHSE&I emphasised the flexibility of the NHS workforce, as evidenced throughout the pandemic.

NHSE&I emphasised the flexibility of the NHS workforce, as evidenced throughout the pandemic. It said that this workforce flexibility now needed to continue as part of transforming the NHS for the future and recovering elective and cancer care.51 In written evidence, the Health Foundation told us that serious staff shortages …

Government response. 3.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2023 3.2 Ensuring that the NHS has a workforce in the right numbers and with the right skills to deliver service commitments to patients is crucial. The government …
HM Treasury

Oral evidence sessions

1 session
Date Witnesses
15 Dec 2021 Amanda Pritchard · NHS England, Matthew Style · Department of Health and Social Care, Professor Stephen Powis · NHS England, Sir Chris Wormald · Department of Health and Social Care, Sir James Mackey · NHS England View ↗