Tackling the backlog: solutions and strategies

Despite delivering an impressive 23 million episodes of elective care since the beginning of the COVID-19 pandemic, as well as providing care for over 600,000 COVID-19 inpatients, the NHS has been placed under immeasurable strain during this time. Consequently, we are now faced with a waiting list for elective care for over 6 million people in England¹ (4.4 million pre-pandemic). We therefore expect the waiting list to rise even further before meaningful progress is made in tackling this problem. With ongoing challenges including staffing, additional infection prevention protocols, the COVID-19 vaccine programme and other operational demands, it is evident that it will take a significant period of time to begin to reduce this backlog and clear strategies must be put in place in order to do so. 

Also evident from data analysis is that the scale of the elective backlog varies between geographical areas, with those living in the most deprived areas nearly twice as likely to wait more than a year for treatment compared with those living in the least deprived areas.² This fact alone should indicate that a prescriptive approach is unlikely to be broadly successful in reducing waiting list numbers, but rather we should be looking at tailored solutions for individual NHS Trusts. In doing so, we could ensure the specific challenges faced by a Trust are really being answered by the solution put in place. 

This approach would also aid the NHS in meeting the targets recently set by the Secretary of State for Health & Social Care in the published four stage strategy for tackling the backlog.³ These targets include having no patients waiting longer than a year for treatment by March 2025, no patients waiting longer than 18 months by April 2023 and no patients waiting longer than two years by July 2022.