Longer waits, missing patients and catching up How is elective care in England coping with the continuing impact of COVID-19?

Summary

This analysis, from The Health Foundation, looks at what we know about the impact of the second wave of the COVID-19 pandemic on elective care in England.

Content

Key points:

• While the NHS delivered a remarkable amount of elective treatment during the second wave of the pandemic, the pressure of caring for large numbers of patients seriously unwell with COVID-19 has led to longer delays for the growing number of patients on the waiting list.
• Data on clinical pathways show that four million fewer people completed elective treatment in 2020 compared with 2019 (down from 16 million to 12 million).
• The rapid expansion of remote consultations helped limit the disruption caused by the pandemic, but patients who need to be admitted to hospital for treatment are tending to wait longer than those who can be diagnosed and treated remotely.
• Services in every part of England were placed under enormous strain during the pandemic, but the varying impact those pressures had on routine hospital services broadly reflects regional differences in COVID-19 infection rates and hospitalisations.
• Just as COVID-19 has exacerbated existing inequalities in other parts of life, access to elective treatment fell further in the most deprived areas of England during 2020 than in less deprived areas.
• As well as fewer patients being treated, 2020 saw six million fewer people referred into consultant-led elective care than in 2019. These 'missing patients' remain the biggest unknown in planning to address the backlog of unmet need created by the pandemic.
• The waiting list has now reached the highest level since comparable records began, with more patients experiencing long delays in diagnosis and treatment. The waiting list could still grow substantially depending on how and when the 'missing patients' are belatedly added.