Nuffield Trust - The elective care backlog and ethnicity (3 November 2022)

Summary

It is well known that pausing planned hospital care during the pandemic worsened growing waiting lists, and that waits for routine care now stand at record-breaking levels. This research from the Nuffield Trust, supported by the NHS Race and Health Observatory, looks at how the fallout from the pandemic affected people across different ethnic groups, and whether that impact was spread evenly.

Content

Key findings

• Before the pandemic, the White group had higher rates of elective procedures overall than the Black, Mixed and Asian groups, with the White group having almost a fifth more procedures than the Asian group per head of population. Cardiac and cataract procedure rates were highest in the Asian group and dental procedure rates were highest in the Black group.
• Procedure rates during the first year of the pandemic fell in all groups, with the NHS carrying out around 2.7 million fewer operations and tests in that year compared with the year before.
• However, the falls in activity were not uniform across the different ethnic groups, with the Asian group experiencing the largest overall fall in the first year of the pandemic compared with the other groups (a fall of 49% for all procedures compared with 44% for the White and Black groups). This means that if the proportional fall in activity was the same for the Asian group as it was for the White group, we would have expected to see just over 17,000 more procedures for the Asian group.
• Although the gap narrowed in the second year of the pandemic, there was still a larger deficit of care among the Asian group, with the fall remaining 2% larger for the Asian group than for the White group – an estimated deficit of 6,640 procedures.
• Apart from the Asian group, consistent differences were not found across procedures for other ethnic minority groups. The Black group did have larger rate falls than the White group for cardiac and cataract procedures (the fall was 19% larger for cataract procedures) but otherwise saw similar changes to the White group, including for all procedures taken together.
• The most deprived groups in the population experienced larger rate falls overall and for most specific procedure groups. For hip and knee replacements, there was a 13% larger fall in the most deprived group compared with the national change, and a 7% lower fall in the least deprived group.
• There was no relationship between the fall in elective hospital activity and the local impact of Covid-19 by region (as measured by reported Covid-19 cases and Covid-19 admissions).