NAO report points to critical pressures on the NHS

NHS waiting list in England could double by early 2025, the National Audit Office (NAO) warned today, adding that the system faces a ‘daunting’ task. The need for more help from the private sector is imperative, HealthInvestor UK understands.

According to the NAO report on NHS backlogs and waiting time, the number of patients on waiting list for elective care stands at a record high of roughly six million.   

There is a real risk that the waiting list will be longer in 2025 than it is today, NAO said.  In less than three years, up to 12 million elective care patients could be on waiting list.

As for NHS cancer services, by June this year, activity had recovered to pre-pandemic levels. But since the start of the pandemic – up to September 2021 – patients with an urgent GP referral for cancer were more likely to be delayed. Astonishingly, 26% had to wait more than 62 days for treatment to start.  

Responding to the report, Independent Healthcare Providers Network chief executive David Hare highlighted the importance of procurement to the private sector: “Today’s NAO report on the NHS elective care backlog highlights the significant pressures on the NHS, and that despite the tireless efforts of healthcare staff all around the country, millions of patients are finding it increasingly difficult to access the care they need. 

“Given the scale of the challenge, it’s vital that the government’s forthcoming elective care recovery plan ensures that all available resources are deployed to tackle the backlog. This includes the use of independent sector providers, which the NAO’s report makes clear played a key role in ensuring non-covid services could continue during the pandemic, with the delivery of over 3.3 million NHS procedures.” 

In March, the NHS signed a four-year, £10 billion Increasing Capacity Framework (ICF). Under the procurement framework, the NHS pays around 90 private healthcare providers according to the number of patients they treat.  

A spokesperson from Nuffield Health, which is included in the ICF list, told HealthInvestor UK: “ In our hospitals across the UK, we are seeing self-pay demand exceed levels of activity experienced for the same period before the pandemic. Our hospitals across the UK have cared for over 440,000 NHS patients so far as part of national and local agreements with the NHS while our free Covid-19 Rehabilitation Programme has to date helped over 1,200 people across the UK to recover from the prolonged effects of Covid-19.” 

Asked how Nuffield Health will support the NHS this winter, he says: “We are committed to supporting the health and wellbeing needs of our local communities. We do this by providing extra capacity to our local NHS trusts, keeping people fit, healthy, and out of hospital through our connected health and wellbeing services. Additionally, we provide free and low-cost community services such as our Covid-19 rehabilitation and joint pain programmes. We also provide self-pay services for those who choose to pay for health services.” 

A HCA Healthcare UK spokeswoman adds: “HCA Healthcare UK does not routinely do NHS elective work, instead we continue to support NHS trusts in London, Manchester, Southwest and Southeast regions and the Midlands to provide complex care. This is reflective of the infrastructure, expertise, and capability across our system of hospitals. For example, we are working with trusts to provide robotic surgery, complex cancer surgery, cardiac care and cardiac surgery and neuro-spinal surgery.”

Top private hospital player Ramsay Health Care UK has not responded to our request for comment while Spire Healthcare, Circle Health, and Practice Plus Group declined to comment.  

Overall, the NAO report addresses how tackling the difficulties ahead will require extra beds, managing staff shortages, and ensuring that existing health inequalities are not perpetuated or exacerbated. 

To support the recovery of elective care, the UK government is providing the NHS with an additional £8 billion between 2022-23 and 2024-25. It expects the NHS to increase elective care activity by 2024-25 – up 10% from its pre-pandemic plans.   

Date published: December 1, 2021

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