Recommendation 5

HM Government Accepted

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 not come forward for treatment so far during the pandemic, a significant proportion of whom may do so in the coming years. A number of tools have been made available to regions and systems to support the development of robust activity plans for the remainder of this year, as part of the formal activity planning process for the period. Since September 2020, NHSE&I have published analysis on the recovery of urgent cancer referrals and first treatments by age, sex, ethnicity, and deprivation. Support has been provided to address variation in a number of areas such as establishing regional and national cancer teams, collaborative work with Getting It Right First Time (GIRFT), a national programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. Improvements across the NHS in planning and delivery of all services, such as addressing the 104+ week waiters are a key priority along with minimising urgent cancer backlogs. 6: PAC conclusion: 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. 6a: PAC recommendation: The Department and NHSE&I must be realistic and transparent about what the NHS can achieve with the resources it has and the trade- offs that are needed to reduce waiting lists. In implementing its elective recovery plan, NHSE&I should set out clearly what patients can realistically expect in terms of waiting times for elective and cancer treatment. 6.1 The government agrees with the Committee’s recommendation. 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 the response to recommendation 2, NHS England also published the Elective Recovery Plan in February 2022. This plan sets out a clear vision for how the NHS will recover and expand elective and cancer services over the next three years, and what patients can expect. There are also clear goals and objectives set on prioritisation within the Recovery Plan. This allows better understanding of future demand, with further updates to be provided later in the year. 6.4 All of the above however, is subject to demand and capacity levels similar to pre-covid, whilst also maintaining low levels of Covid across the NHS. 6b: PAC recommendation: By the time of the next Spending Review at the latest, the Department and NHSE&I should have a fully costed plan to enable legally binding elective and cancer care performance standards to be met once more. 6.5 The government agrees with the Committee’s recommendation. 6.6 The Elective Recovery Plan sets out goals for this Spending Review period to use the current funding settlement to maximise elective performance. 6.7 However, as referenced in the response to recommendation 2, there remains both short-term and long-term uncertainty around capacity and demand because of the pandemic and its impact. Ahead of the next Spending Review settlement process, the department will work closely with NHSE&I and other stakeholders to develop funding proposals for the next SR period to be submitted to HM Treasury, using the latest data available at the time.