COVID-19 backlog not likely to be cleared by 2025, even with 30% capacity boost

Experts underscore the need to improve healthcare system resilience to reduce the effects of any future emergencies   

NHS England will not be able to clear the COVID-19 backlog before the end of 2025 even if the system capacity is increased by 30 per cent compared to pre-pandemic levels, according to a new study published in the Lancet.

Researchers from the Universities of Edinburgh and Strathclyde evaluated the impact of the pandemic on NHS waiting times for elective hospital care.

At the end of October 2022, there were more than 7.2 million patient referrals waiting for treatment in England, an increase of 2·6 million from February 2020, when the total pending referrals was 4·6 million.

In January 2012, the number of pending referrals was 2·4 million, and the list increased by about 2·2 million in the eight years before the pandemic between January 2012 and February 2020.

The statistics indicate that the service was already struggling to keep up with the demand many years before the pandemic, and the disease outbreak only aggravated the problem, said Dr Syed Ahmar Shah from the University of Edinburgh’s Usher Institute, who led the study.

However, the experts assumed that the true backlog could be much higher, as large numbers of patients have still not come forward for care.

Their models estimated more than 10 million missing referrals from the beginning of the COVID-19 pandemic to Oct 31, 2022.

NHS England's COVID recovery plan aims to deliver around 30 per cent more elective activity by 2024/25 than before the pandemic, through a range of measures, including extra staff and increased use of the independent sector.

Even with this much increase in system capacity, several years would be needed to clear the backlog, the researchers said.

They suggested that the system capacity should be increased by more than 10 per cent to reverse the increasing trend in waiting lists.

The experts underscored the need to improve health-care system resilience to minimise the effects of any future emergencies on the provision of routine care.

“Moving ahead, it is evident that we cannot afford to leave our healthcare systems strained; instead, we must enhance their resilience to ensure better preparedness for any future emergencies,” Dr Shah added.