NHS ‘may need to prioritise those in need’ rather than patients waiting longest

Patients unable to work may need to be prioritised for NHS treatment rather than the focus being on those who have waited the longest, a senior health leader has suggested.

Chris Hopson, chief executive of NHS Providers, said clearing the backlog of patients who need NHS treatment will take years not months as staff deal with the consequences of the Covid-19 pandemic.

Figures out last week showed that the number of people in England waiting to start hospital treatment had risen to a record high.

Some 4.59 million people were waiting to start treatment at the end of January, the highest number since records began in August 2007.

The number waiting more than 52 weeks to start treatment stood at 304,044 in the same month – the highest number for any calendar month since January 2008. In January 2020, the figure was 1,643.

Mr Hopson said it was uncertain at the moment how big the treatment backlog would be as staff were still dealing with coronavirus.

“The NHS will obviously go as fast as it can, as we always do,” he said.

“But it’s already apparent that clearing the entire backlog will take years rather than months.”

He said the next “real question” would be about who is prioritised for care.

He added: “The NHS is obviously now concentrating on the most urgent cases that had to be delayed for a few days or weeks as a result of the last phase of the pandemic. Trusts are making good and rapid progress here.

“Longer term, there will inevitably be pressure to prioritise those who have waited more than a year as the size of increase here is getting the most media and political attention.

“But trust leaders want to avoid a simplistic approach that only focuses on those who have waited longest.

“We know there will be people who have greater clinical need – people whose lives could be permanently scarred by serious long-term illness or who would never be able to go back to work – who will not be in the 52-week plus category.

“So we need sophisticated prioritisation based on local clinicians’ judgments, rather than being led by what politicians or some in the media are saying about people waiting more than 52 weeks, important though all of these cases are.

“The NHS has always prioritised treatment on the basis of clinical need and we shouldn’t allow the way we measure waiting lists divert us from this approach in this new situation.”

NHS England data shows there was a 54% drop in the number of people admitted for routine treatment in January compared with a year earlier.

Some 139,378 patients were admitted for treatment during the month, compared with 304,888 in January 2020.