£73 billion at stake if government misses its NHS waiting list ambitions, IPPR report finds

• Record NHS waiting list numbers and millions unable to work due to sickness are harming economy, says IPPR
• Meeting government’s own target would bring benefits worth £73bn over five years - but NHS currently not on track
• Report comes after Chancellor's ‘back to work’ budget highlighted value of health, but failed to make any pledge on NHS

Getting people off waiting lists would bring benefits equivalent to £73 billion between now and 2027, according to new research from IPPR and LCP Health Analytics.

The case for reducing waiting lists for non-emergency hospital treatment has historically been made with reference to the human cost. But IPPR’s new report examines for the first time the diverse economic benefits of tackling the backlog, including putting a value on non-monetary benefits not included in traditional measures of economic output (GDP).

One in eight people in England, a total of 7.2 million people, are on an NHS waiting list for operations from hip replacements to cataract removal, or treatment for conditions such as endometriosis – so-called ‘elective treatments’ - which have significant impact on a person’s quality of life and worsen if not treated promptly.

The government and NHS England’s post-Covid-19 Elective Recovery Plan commits to delivering 30 per cent more treatments a year than before the pandemic, by 2025. This would mean 18 million completed treatments over the next five years, IPPR’s report finds – bringing NHS elective waiting lists below half a million by the end of 2026. However previous research has found fewer people have been treated from the waiting list since the plan was published in 2022 than were treated during the same period in 2019.

If the NHS Elective Recovery Plan were achieved, analysis by LCP Health Analytics for IPPR (using a model developed by the Department of Health) shows that this would deliver total benefits worth at least £73 billion over five years. These are:

• £18 billion generated through people returning to work or increasing the number of hours they work - directly increasing GDP.
• A further £55 billion benefit generated through work people do that helps others and society, but for which they are not paid – so does not itself count towards GDP. This includes childcare, caring for sick or elderly relatives, unpaid domestic work and volunteering, all contributing indirectly to the UK economy.

The analysis also finds £14 billion would be saved by government and households through lower spending on health and social care services and informal care services.

To cut waiting lists, and gain the full economic benefits as a result, the government and the NHS need to make a number of reforms swiftly. IPPR calls for 10 key changes – most already tried and tested - that could be made now by health service leaders across the country. These include:

1. Provide elective treatments on the weekends: It is difficult to deliver against the government’s target without completing elective operations on the weekend. Staff should be pooled across hospitals in a region and encouraged through ‘surge’ pay to pick up weekend shifts.
2. Create regional waiting lists: Most patients are referred to a specific hospital and must wait in that queue, even if an earlier option becomes available elsewhere. Creating regional waiting lists would lead to faster treatment for patients willing to travel.
3. Cut some routine follow-up appointments: Most patients are automatically booked in for these regardless of whether they are needed. Instead a patient-led approach to follow-up appointments would cut waste and give choice to patients.
4. Invest in social care workforce: Too many people are unable to be discharged from hospital, despite being medically fit enough, because of the lack of social care. Recruiting and training more social care workers is perhaps the single most effective way to open up hospital beds and reduce waiting lists.

Lord Ara Darzi, leading surgeon and co-chair of IPPR’s Commission on Health and Prosperity, said:

“Too often, politicians have seen healthcare as a cost to be contained, rather than an opportunity to deliver better lives and greater national prosperity.

“The NHS has made genuine progress in reducing the number of people waiting over two years for treatment. This report shows there is a convincing, economic case to go yet further and faster. The NHS has a track record of dramatic improvements in waiting times. With the right resources, we can do it again.

“This report also highlights a series of compelling levers that policymakers can use to speed up progress. Getting people off the lists and back to work is good for their own quality of life, and it is also good for the economy.”

Professor Dame Sally Davies, IPPR Commission on Health and Prosperity co-chair, former chief medical officer for England and master of Trinity College Cambridge said:  

"Covid-19 showed how vulnerable our lives and prosperity are to illness. It is time for policy makers and politicians to wake-up to the pivotal role of good health in good lives and a strong, fair economy. 

“This report's findings are clear: a flourishing NHS as a springboard for growth, not just a cost to be contained. It outlines a compelling, new case to go further and faster on reducing NHS waiting times and waiting lists, to deliver better, more prosperous lives across the UK.” 

Dr Parth Patel, senior research fellow at IPPR and an NHS doctor, said:

“It’s often said we need economic growth to support the NHS, but right now we need the NHS to support the economy. The UK is on track to be the worst performing advanced economy this year. Fixing the crisis in our health service should be a top priority for policymakers, but there was no mention of it in the Chancellor’s spring budget.

“The government urgently needs to bolster the health and social care workforce, while local NHS leaders should be given the power to redesign how services work for patients.

“For too long the NHS has just been viewed as a cost, but better healthcare is a springboard for a better economy.”

Dr Jonathan Pearson-Stuttard, head of health analytics at Lane Clark & Peacock (LCP), chair of the Royal Society for Public Health and vice chair of IPPR’s Commission on Health and Prosperity, said:

“This report highlights how the richness of data could be used to target health driven prosperity where it is needed most. Despite good progress against the very long waiters target, inequalities by geography and specialty persist across the elective waiting list. Timely data and applied analytics can ensure action is targeted to these areas proportionately to improve the public’s health.”

ENDS

Dr Parth Patel, a co-author of the report and also an NHS doctor, is available for interview

Chris Thomas, head of IPPR's Commission on Health and Prosperity, is also available

CONTACT

David Wastell, Director of News and Communications: 07921 403651 d.wastell@ippr.org

NOTES TO EDITORS

1. The IPPR paper, Waiting for prosperity: Modelling the economic benefits of reducing NHS elective waiting lists, by Anne Williamson and Dr Path Patel, is published at 0700 on Monday April 3. It is available for download at: http://www.ippr.org/research/publications/waiting-for-prosperity
    
2. The projected £18 billion gain in paid production will directly increase output, measured in standard GDP (gross domestic product). The value of the £55 billion increase in unpaid activity would not itself represent an increase in GDP. But some of that activity may release other people from (for example) unpaid caring to return to paid work, or to extend their paid work hours, which would increase measured GDP. However a firm estimate of this and other secondary impacts is beyond the remit of this paper.
    
3. Health and social care savings have a more ambiguous effect on GDP – a fall in spending could reduce measured GDP - but are likely to allow funding to be redirected to more productive health programmes.
    
4. Methodology: Working with LCP Health Analytics, IPPR estimated the economic impacts of reducing elective waiting lists in four steps:
   - First, we model NHS elective waiting list trajectories (using data from NHS England).
   - Second, we estimate age distribution of elective waiting lists by speciality (using data from Hospital Episode Statistics).
   - Third, we model pre-treatment quality of life for patients on elective waiting lists by speciality (using analysis from the University of York) and apply a speciality-specific scaling factor to model post-treatment quality of life.
   - Finally, we use the Wider Societal Benefits model, developed by NICE and the Department of Health, to estimate the economic production and consumption associated with reducing NHS elective waiting lists.
    
5. The Commission on Health and Prosperity is a landmark IPPR initiative, exploring the case that a fairer country is a healthier country, and that a healthier country is a more prosperous country.