The Health Foundation: Elective care in England. Assessing the impact of COVID-19 and where next (11 November 2020)

Summary

New analysis by the Health Foundation shows there were 4.7 million fewer people referred for routine hospital care – for things like hip, knee and cataract surgery – between January and August 2020 compared to the same period in 2019, representing a potential hidden backlog of unmet care needs.

The research highlights the scale of the challenge facing the NHS as it looks to resume services following the disruption caused by the first wave of COVID-19. The number of patients in hospital with COVID-19 is growing as we head into winter, a time when the NHS always experiences greater pressures from flu and other seasonal illnesses. If the virus is not controlled and emergency pressures surge, even more routine treatment will need to be postponed which will only add to the challenge of recovering from the pandemic.

Content

Detailed results from the report show:

• The regions that have seen the sharpest decline in the number of people referred for routine elective care during the first 8 months of the year are London (37% reduction as compared to 2019), North West (35% reduction) and South East (35% reduction). The South West saw the smallest reduction in the number of people referred for elective care compared to 2019 (29%). The North East and Yorkshire saw a 34% reduction and Midlands and East of England both had a 33% reduction.    
• Those regions that experienced the lowest rates of COVID-19 during the first wave, namely the South West and East of England, are also those that have made the most progress in reopening elective care services. While there are currently only limited signs that more treatment is being postponed in the regions hardest hit by COVID-19, this may change in the future.

Referrals to clinical areas have declined as follows:

• oral surgery (43% lower than in 2019, representing 177,591 fewer people)
• trauma and orthopaedics (42% lower, representing 622,593 fewer people). This includes surgery for hip and knee replacements
• ophthalmology (41% lower, representing 531,660 fewer people). This includes cataract operations
• thoracic medicine (29%, or 98,546 fewer people) cardiothoracic surgery (29%, or 7,889 fewer people)
• neurosurgery (29% lower, or 23,872 fewer people); urology (28% lower, representing 186,119 fewer people).