Tackling waiting lists with flexible capacity

The elective surgery waiting list has continued to grow and millions of people are now waiting for a procedure in England. Capacity limitations during the pandemic – in terms of staff, equipment and physical space – in combination with lower activity levels, have meant that recovery has been slower than hoped. It is clear more capacity is needed to tackle the backlog, but with the need so substantial, where will this additional capacity come from?

While building new hospitals and operating theatres is an option and may be the answer in the longer term, new facilities take time to plan and build – in many cases years. The problem is that during that time the backlog will continue to build, causing further delays to recovery, which means even more resources will be needed to catch up. 

Capacity can be released internally by improving effectiveness in existing operating theatres by fitting in more patients or working longer hours, but with staff shortages, COVID-19 and a need for social distancing, that has been difficult to achieve without additional physical capacity. At a national level at least, there are few signs of real improvement, despite efforts by individual Trusts. Longer waits can have a serious impact on patients. The very term ‘elective procedures’ is increasingly misleading and implies that patients have a choice of whether or not to go ahead with an operation. The reality is that many of those patients will be experiencing increasingly chronic pain and impairment to their lives, and the majority will not consider their procedure a choice, but a necessity.