Intended for healthcare professionals


Covid-19: NHS to trial rapid diagnostics and Saturday clinics to tackle elective care backlog

BMJ 2021; 373 doi: (Published 13 May 2021) Cite this as: BMJ 2021;373:n1243
  1. Gareth Iacobucci
  1. The BMJ

NHS England is to invest £160m (€186m; $225m) to test new initiatives to reduce the hospital waiting lists that have soared to 4.7 million people during the covid-19 pandemic.

Selected areas of England will test quicker access to diagnostic testing at one stop facilities, pop-up clinics to treat and discharge patients closer to home, Saturday specialist clinics staffed by multidisciplinary teams, and “virtual wards” to assess people at home.

A high volume service for removing cataracts in a day, 3D eye scanners, antibiotic kits to use at home, “pre-hab” for patients before surgery, artificial intelligence in GP surgeries, and greater access to specialist advice for GPs will also be trialled across a dozen areas and five specialist children’s hospitals.

Amanda Pritchard, the NHS’s chief operating officer, said, “With covid cases in hospitals significantly reducing thanks to the extraordinary success of the NHS vaccination programme, our focus is now on rapidly recovering routine services.”

The funding—which is additional to the £1bn previously allocated for backlog recovery in England—is designed to test approaches to reduce hospital waiting lists and develop a “blueprint” for other areas of the country to adopt.

NHS England said that while elective activity was recovering faster after the second wave of the pandemic than it did last year, it wanted to accelerate the recovery through the pilots. Its aim is to increase the number of elective operations, tests, and treatments at each pilot site, which will receive a share of the £160m to implement and evaluate the initiatives.

Neil Mortensen, president of the Royal College of Surgeons of England, backed the announcement, saying, “2020 was incredibly challenging for the NHS, but in the midst of the pressure, staff and hospitals came up with new solutions to keep urgent surgery going. Operations were scheduled at weekends, ‘surgical hubs’ were created, and groups of hospitals worked together providing mutual aid. Embedding the learnings and innovation is key to the future sustainability of surgical services.”

But Chaand Nagpaul, BMA council chair said £160m was insufficient, noting that the BMA recently estimated1 that £4bn will be needed to clear the backlog of patients in England needing elective care.

“Rather than dangling the prospect of a few million pounds to those healthcare providers who may not really have the staff or the facilities to deliver such ambitious results, NHS England and the government should be focusing on retaining the workforce,” he said.

Nagpaul added that it was crucial that staff and clinicians were engaged in the plans, warning that the idea of GPs providing specialist clinics “shows a grave lack of understanding of the rocketing workload and demand already facing GPs, which includes delivering the largest vaccination programme in the history of the NHS.”

Chris Hopson, chief executive of NHS Providers, warned that, based on current trajectories, getting through the backlog could take between three and five years at some trusts, which was “unacceptable.”

“Once that blueprint has been created, it will be vital for the government to provide the required funding,” he said.

The NHS Confederation backed the pilots, but also urged2 the health secretary Matt Hancock to implement other measures to reduce waiting lists, including reviewing social distancing and infection control measures in hospitals as covid-19 cases come down in order to “free up significant operational capacity across the NHS.”

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