Recommendation 2

NHS England was over-optimistic about the circumstances in which the NHS would be trying to recover elective and cancer care. In our first report on NHS backlogs and waiting times in March 2022, we reported our concern that “officials are too optimistic about the resilience of NHS services in the short- and medium- term, particularly as NHS staff have been working under continuously high pressure during the pandemic”. The recovery plan, however, continued this over- optimism by including assumptions about low levels of COVID-19 and minimal winter pressures, and that activity levels would recover to pre-pandemic levels early in 2022–23. Between April and August 2022, elective activity was at just 95% of pre-pandemic levels. The reality has been that the NHS continues to manage other major pressures, including ongoing effects of COVID-19, access to primary care, the performance of urgent and emergency care, workforce gaps, and problems with the supply of adult social care. NHSE told us that it would need to “reprofile” the trajectory of the recovery if it was to reach 129% during 2024–25. Macmillan Cancer Support and Healthwatch Suffolk submitted evidence to us with powerful examples of the uncertainty, anxiety and other problems experienced by long-waiting patients. Recommendation: NHS England and the Department of Health and Social Care should revisit their planning assumptions for the recovery and publicly report any updates to targets so that patients and NHS staff can see a clear and realistic trajectory to achieve the 62-day cancer backlog target, the 52-week wait target for elective care, and, ultimately, the 18-week legal standard for elective care.