Yesterday (8 February 2022) we heard the government set out its plans to tackle the long-standing backlog of elective care and to reduce waiting times for cancer treatment. For further information, the full report can be found here.
This plan follows the NAO report on the backlog and waiting times that was issued on 1 December 2021 and reported on here: https://blog.burges-salmon.com/post/102hcra/nao-publishes-report-on-nhs-backlog-and-waiting-times
The plan predicts to increase the amount of elective care activity to 30% above pre-pandemic levels by 2024.
The elective care backlog was already significant before the pandemic, at 4.4million. It has grown to c. 6 million, and will continue to rise before it falls, potentially as high as 10 million, as people become more willing and able to come forward for care once the pandemic eases.
In an effort to “transform elective care”, there will be £2 billion of funding for elective recovery this year and £8 billion over the next 3 years, plus an extra £6 billion towards capital investment for beds, equipment and technology, although it is unclear how much of this funding has been previously announced.
1. Increasing capacity
Government plans for there to be more doctors, nurses, medical students and clinicians on the frontline. There is an acknowledgement of the key role that the independent sector has played in the pandemic effort and its role will continue as the sector is utilised more to help patients access the services they need.
2. Prioritising treatment
In conjunction with the government’s “10-Year Cancer Plan: Call for Evidence” launched last week, the elective plan focuses on restoring cancer services following the COVID-19 backlog. The target is to have 75% of patients diagnosed or cancer ruled out within 28 days by March 2024. Waiting lists will be analysed according to demographic, as deprived areas are more likely to experience delays.
Campaigns will also intensify to encourage more people to come forward for checks, treatment and care.
The plan aims to reduce waiting lists by March 2024, with waits of over 18 months to be eliminated by April 2023. All elective care waits are to be eliminated by March 2025. No one will wait longer than 2 years, with 99% of patients waiting less than one year.
3. Transform the way elective care is provided
The number of people receiving a diagnostic test within 6 weeks was at 96% pre-pandemic, but has since fallen to 75%. The aim is to get this back to pre-pandemic levels by March 2025.
The use of Community Diagnostic Centres (CDCs) is to expand as one-stop-shops for checks, scans and tests. 69 CDCs are currently operational; the intention is to have at least 100 over the next 3 years. There will also be increased use of surgical hubs dedicated to elective surgeries to fast-track operations.
4. Better information and support to patients
The information and support for patients will improve following the launch of “My Planned Care” later this month. The online platform will offer patients and carers tailored information, details of waiting times, and personalised support ahead of surgery. This is to reduce the number of “on the day” surgery cancellations, which currently represents 1/3 of patients.
Commentators have been quick to highlight the absence of a developed workforce plan. The acute workforce shortages and skills gap was a significant issue before the pandemic (and before Brexit) and is even more so now, not least with alterative careers (with lower skill level requirements) paying at the same or a higher level than many care roles. Despite the government’s claim about record recruitment levels, it is unclear if the figures take into account the leavers from the NHS and social care roles.
The role of the independent sector in increasing capacity appears to be key, but it does require further clarification. The stated delivery plan for increasing capacity refers to the potential for Integrated Care System (ICS) boards to have independent provider representation. But the key here will be the extent to which local ICS’ proactively engage with independent providers, and consider the potential they have to alleviate capacity issues, when organising the way in which local care is delivered. Further clarity is needed on how the impending NHS Provider Selection Regime will operate in practice and how the decisions that are made will be scrutinised so that objective decisions can be made on the inclusion of independent providers in the delivery of care.
Blog post co-written by Isabel Rawlings (Trainee Solicitor).