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Covid-19: NHS leaders braced for longer waiting times as service deals with fallout

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2639 (Published 01 July 2020) Cite this as: BMJ 2020;370:m2639

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  1. Gareth Iacobucci
  1. The BMJ

Waiting times for tests and treatment not related to covid-19 are likely to increase significantly in the second half of 2020 because of the fallout from the pandemic, the head of NHS England has acknowledged.

Giving evidence to the Commons health select committee on 30 June, NHS England’s chief executive Simon Stevens said that contrary to some commentary, the NHS’s overall waiting list actually dropped by over half a million people between February and April 2020 because fewer people were coming forward for treatment.

But, he added, “As referrals return we expect that will go up significantly over the second half of the year.”

Stevens said that there were 725 000 fewer elective admissions to NHS hospitals during March and April, but that number has begun to recover significantly. “As we speak, we think we’re now somewhere north of 55% of pre-covid-19 elective activity levels,” he said. He added that he hoped the NHS would return to around three quarters of normal activity levels by July or August.

Stevens told MPs that the NHS would pursue a range of measures to increase capacity over the coming months, including extending the deal with the private sector to use its facilities, and repurposing some of the Nightingale hospitals for diagnostic testing.

Noting that four fifths of patients on NHS waiting lists are waiting for a test or outpatient appointment rather than an operation, he said, “We’ve got to expand diagnostic capacity and we’ve got to do it in new ways. This will be particularly true for endoscopy, particularly bowel cancer services. We’re looking for a radically different model for endoscopy investigations.”

Stevens said that this would include expanding the use of non-invasive methods for screening and setting up dedicated diagnostic and endoscopy suites doing three sessions a day. “The first of those is going to be the Exeter Nightingale which we are going to partly repurpose for non-covid-19 scanning. That will begin next Monday and run 8 am till 8 pm, seven days a week,” he said.

Chris Hopson, chief executive of the hospital trust representative body NHS Providers, said the government would also need to fund extra bed capacity to help deal with the backlog.

“We need to ensure that we carry on using that independent sector capacity. We need to keep the Nightingales in some form. We also know that we simply don’t have enough general acute beds, so we need to have that extra bed capacity funded,” he told the committee.

Their comments came as a poll by the Royal College of Physicians found that almost half of physician specialists expect to be working at less than previous pre-covid-19 activity levels for at least 12 months.1

Also appearing before the committee, RCP president Andrew Goddard said that doctors were particularly concerned about next winter. “Everybody in the medical profession is worried,” he said. “We could be hit with a double whammy of a big flu season and a big second wave. How much that’s going to impact on our ability to catch up is perhaps people’s biggest concern.”

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