A survey of trust leaders by NHS Providers has revealed
widespread worries that rapidly growing waiting lists will worsen
existing health inequalities.
All trust leaders who responded said they were concerned,
including 66% who were very concerned.
The findings come amid growing evidence of the damaging impact of
the pandemic on health inequalities, as highlighted recently by
NHS Providers’ recent report: Health inequalities: A
core concern.
They also reflect concerns about the time it will take to recover
the care backlog, despite impressive progress by trusts and
frontline staff in restoring services. Almost a third of leaders
(32%) said it will take three to five years.
These findings come ahead of the publication later today of the
latest NHS performance data, which are expected to confirm the
unrelenting pressure on the health service as we head into
winter.
A record 5.6 million people are currently on waiting lists for
planned procedures with over one and a half million waiting to
access mental health services. Urgent and emergency care services
face incredibly high demand with similar pressures across
community services.
Trusts and frontline staff are working incredibly hard to bear
down on the backlog of care but this survey highlights the
growing scale and complexity of demand.
As part of our submission to the National Audit Office inquiry on
NHS backlogs and waiting times, our survey of 170 trust leaders
from 119 trusts (56% of the provider sector) found:
- Most trust leaders (66%) were very concerned that
backlogs in care will further exacerbate health inequalities.
- Mental health services (specifically children and young
people’s and eating disorders), urgent and emergency care and
cancer services top trust leaders’ concerns.
- 87% of trust leaders said they were now seeing patients with
more complex and acute needs compared to before the pandemic with
figure reaching 94% for mental health and learning disability
trusts and 91% for community trusts.
- 96% of respondents stated that the current level of
demand was significantly increasing (64%) or moderately
increasing (32%) across all services
provided. This figure was 100% for ambulance
trusts and 96% of community service.
- Almost one third (32%) of respondents felt that it would
take three to five years for their trust to tackle the backlog of
care.
Commenting on the survey results, the deputy chief executive of
NHS Providers, Saffron Cordery said:
“Our survey reveals the sheer scale of the challenge that trusts
are now managing. Trust leaders are fighting fires on multiple
fronts as they try to recover care backlogs, deal with increased
demand for emergency care, treat patients with COVID-19 and
prepare for what is likely to be the most challenging winter yet
for the NHS.
“In a matter of weeks, we will face our first winter where both
flu and COVID are in circulation. NHS staff are doing all they
can to bear down on the care backlog, but the reality on the
frontline is that even a small increase in flu, COVID-19
admissions or emergency care attendance will really increase the
pressure on the service.
“The impact the care backlog could have on worsening health
inequalities weighs heavy on the shoulders of trust leaders. It
is hugely reassuring then that they are working with partners
across the health and care system to manage waiting lists to
prioritise the sickest patients. It is reassuring that a quarter
of trusts said an ICS wide approach to managing waiting lists had
been extremely or very helpful in tackling health inequalities.
“It is also positive to hear trust leaders are using digital
innovations such as the continued use of virtual appointments
where appropriate, and digital transformation of some manual
processes to reduce the administrative burden on clinicians,
freeing up more time to care for patients and to increase
elective activity and manage waiting lists.
“But the key intervention NHS leaders tell us they need is new
staff to support their plans. We must not forget that the service
entered the pandemic with over 100,000 workforce vacancies. We
need a fully costed and funded multi-year workforce plan sooner
rather than later”.
