Oli Hudson, content director at Wilmington Healthcare, explores the NHS’s gravest challenge for 2022 – the elective care backlog – and how it affects industry.
At least 5.8 million patients are now part of the NHS’s elective care backlog.
Of these, 300,000 have been waiting more than a year and 12,000 more than two years.
December’s report from the Health and Social Care Select Committee highlights how unmanageable a challenge the backlog had the potential to be.
Health secretary Sajid Javid said in July that, when taking into account all “unknown” patients, this figure could rise to 13 million – placing something like one fifth of the population on a waiting list for treatment.
Government has announced financial support to tackle the backlog, including an extra £5.4 billion over the six months from September 2021 to support the NHS response to COVID-19 and help tackle waiting lists this year, and a further £36 billion in health and social care over the next three years funded by a Health and Social Care Levy to be introduced from April 2022. Questions remain over whether this will be enough.
Meanwhile, it remains the number one issue for medtech’s NHS customer. Industry engagement with the NHS is currently fraught with time-poor staff. That’s why it’s important that medtech takes on board the depth of all this when presenting its value proposition.
Here are some ways the backlog is causing issues.
Challenges for the whole healthcare sector
The backlog is causing people to die before their time, with 86% of clinicians surveyed by the one association agreeing that some patients are now terminally ill due to either a late diagnosis or treatment delays.
The most immediate thought one has about the backlog is that it is a secondary care issue – and it is true that issues there are grave.
The Government-mandated catch-up process has resulted in unsustainable patient numbers for staff and total numbers of beds occupied, as well as endless and constant pressure on theatres, on inpatient wards, on numbers recovering in hospital.
The backlog is rightly seen as an issue creating problems for secondary care, but it is one that challenges every sector of health and social care.
Firstly, it puts pressure on primary care, who must manage this ever-increasing queue of patients out-of-hospital, with increasingly exacerbating conditions in many cases.
Secondly, upon social care, who must do likewise with the limited help of primary and community care staff and have an additional burden of extra residents discharged from hospital to ease capacity in acute care.
Thirdly, on emergency care, who pick up the extra emergencies caused by the exacerbated patients and those who, left untreated, have developed complications or even new morbidities.
Fourthly, on mental health services, who will address the obvious and concomitant mental health need of those waiting to be treated for a life-affecting condition.
Finally, on community care because of an upsurge in demand for certain community services intended to help keep patients out of hospital. For a sense of the scale of the challenge it’s instructive to read the Community services prioritisation framework published in January.
The framework tells leaders and clinicians in some 61 services in the community:
‘Capacity in community services will need to be extended to enable supporting discharge pathways and urgent community response provision, mobilising virtual wards and supporting end-of-life care at home.’
It also states that many services should be completely paused if they might create extra hospital admissions. Other services will introduce a prioritisation and rationing policy.
What this means for medtech
The backlog is going to be front and centre of every NHS clinical customer’s priorities. Industry support on this will be instrumental in opening doors for engagement and providing possible solutions.
These can include products that reduce time spent in hospital, whether through improved outcomes, faster recovery, faster patient throughput and less theatre time, fewer complications and fewer revisions needed.
But products that shift the healthcare settings or pathway from hospital treatment can also assist.
Trusts now have a new urgency, with HSJ reporting senior financial leaders demanding ‘a strong return to payment by results’ to accelerate activity on the backlog.
While the proposed 2022/23 payment system – currently under consultation - seeks to develop a blended approach whereby trusts are paid a fixed amount as well as local incentives to achieve various outcomes – at the moment activity is the key driver. The decisions financial and clinical leaders currently make will have ‘how will this affect admissions and patient numbers’ all over them.
Normal service has not yet resumed in the NHS, and the backlog numbers suggest it won’t for quite some time. Medtech should consider this and place assistance with tackling the backlog at the centre of its offering, wherever possible.
Wilmington Healthcare provides market leading data, insight and intelligence across the healthcare community. Read our latest white paper – Looking Ahead 2022: Challenges and Opportunities for the NHS and Industry here, or find out more about how we can support your NHS partnerships, visit wilmingtonhealthcare.com.
