Conclusion 4

Access to health services has reduced substantially, creating backlogs that will need to be addressed. For several years now this Committee has been reporting on the increasingly poor performance against waiting times standards for A&E and cancer, and the growing waiting lists for elective treatments. To respond to COVID-19, the NHS was told by NHSE&I to suspend elective activity to free up capacity, which will inevitably add even more pressure to waiting lists. Fewer people have been using A&E services, despite NHSE&I encouraging people who should use them to do so. This means that patients in need of urgent care may not be accessing it on a timely basis, creating further demand for services in future. NHSE&I has asked local health systems to step up non-COVID-19 urgent services and consider options to resume non-urgent care. However, there is uncertainty about what capacity is required to deliver services during and following the pandemic, and how this should be allocated. The initial financial arrangements for trusts during the COVID crisis were for the period April to July 2020. Trusts will need guidance and potential financial support to plan beyond the summer and respond to winter pressures, as they are also being required to retain spare capacity for future surges in COVID-19 cases. Recommendation: NHSE&I should clearly set out and communicate to the public the range and extent of health services that will be available, what patients can expect in terms of access and waiting times, and what it is doing to encourage patients to access services when they need to.