The new Health and Social Care Secretary, Sajid Javid, recently warned that the number of people on a waiting list for NHS care in England could reach as many as 13 million. New IFS modelling shows the scale of the waiting list challenge ahead, as the millions who have missed out on care come forward, and the NHS is potentially hamstrung by infection control measures and the continued need to treat a high number of Covid-19 patients.
The analysis shows that whether or not waiting lists rise as far as 13 million depends crucially on the ability of the NHS to expand its capacity and treat more patients than it did pre-pandemic. If that proves impossible, waiting lists could indeed rise to 13 million – or even higher.
NHS waiting lists have grown by less than a million since the start of the pandemic despite there being 3 million fewer planned admissions and 17 million fewer outpatient appointments in the first ten months of the pandemic alone. This is because 7 million fewer people joined the waiting list between March 2020 and May 2021 than would otherwise have been expected. What happens to waiting lists in the short term will therefore depend crucially on what fraction of these 7 million “missing” patients come back for treatment.
In the longer term, NHS capacity to deal with non Covid patients will be crucial. Even if only two thirds of the missing patients return then with capacity at 95% of pre-pandemic levels – much more than the NHS is currently managing – waiting lists could easily exceed 13 million (and keep growing). Expanding capacity will be the only solution to cutting waiting lists in the future.
Finding ways to boost NHS capacity will therefore be a major and pressing challenge for the new Secretary of State and NHS Chief Executive, and will undoubtedly feed into discussions around NHS funding at this autumn's Spending Review.
Max Warner, a Research Economist at the IFS and an author of the analysis, said:
"More than 4 million people were on an NHS waiting list even before the pandemic. Covid-19 has only made matters worse, as millions of people have missed out on treatment and millions more haven't even been referred onto the waiting list to begin with. There is a real risk that if the NHS cannot find effective ways to boost its capacity – a challenge at the best of times, let alone after a major pandemic – then much longer waiting lists will be with us for years to come."