Health Foundation estimate almost £17 billion needed to clear NHS backlog in this parliament

Clearing the NHS backlog could cost almost £17 billion, an independent health charity has said.

The Health Foundation said coronavirus “will cast a long shadow over the NHS for many years to come”, and warned better staffing levels will be needed, as well as investment.

It estimates it will cost up to £16.8 billion over the remainder of this parliament, to clear the backlog and return to the 18-week waiting time standard.

The foundation said analysis from its Real (Research and Economic Analysis for the Long term) Centre suggested this might allow an additional 2.2 million extra patients to be seen a year.

The organisation highlighted two options for the Government – clearing the backlog over the course of this parliament, which it said would require boosting staffing levels and capacity, or tackling the waiting list over a longer period.

It said meeting the target in 2024/25 would mean bringing the waiting list down to 3.8 million by March 2025, whereas tackling the backlog by 2028/29 could mean coping with a waiting list of between seven and 8.5 million in that same period.

The cost of clearing the backlog and having 75% of patients returning over the next eight years would be £12.3 billion, it said, while the cost of doing so over the next four years would be £15.7 billion.

The £16.8 billion estimate relates to not only clearing the backlog but also returning to the standard of patients not waiting more than 18 weeks for treatment.

Its figures do not include the direct costs of Covid-19, such as caring for patients in hospital with the virus, or indirect costs as a result of reduced productivity due to social distancing and enhanced infection prevention and control measures, it said.

While the foundation said this cannot be modelled conclusively because the ongoing impact of Covid on the NHS remains too uncertain, it predicts that for every 1% decrease in productivity, an extra £1.5 billion each year in additional funding will be needed to meet the same care demands.

It said that with ongoing costs from the vaccine programme and other “significant impacts” on the way care is delivered in the NHS, its analysis suggests a greater fall in productivity of 2-4% could cost between an extra £3 billion and £6 billion a year to maintain the same level of care.

This outcome would see the NHS facing funding pressures of between £7 billion and £13 billion in 2022/23, the foundation said.

The NHS workforce could need to grow by more than a third over the coming decade, in addition to recruitment needed to reduce current shortages – potentially seeing levels increase by up to 277,500 full-time equivalent staff by 2024/25, the foundation said.

It estimates the capital budget will need to rise from £6.4 billion in 2018/19 to £10.3 billion in 2024/25 to allow investment in equipment and bed capacity.

The foundation also said a “substantial increase” in adult social care funding would be needed to “expand access to care, pay more for care to sustain the provider sector and pay higher wages”, and estimates extra funding of between £3.7 billion and £7.9 billion in 2022/23 would be needed for these.

It said these estimates, which are equal to or higher than the funding needs of the NHS, reflect to some extent the lack of funding for adult social care over the last decade, compared to the health service.

Anita Charlesworth (pictured), the Health Foundation’s director of research and Real Centre, said: “Covid-19 will cast a long shadow over the NHS for many years to come, even with a successful vaccination programme.”

She added: “Managing the costs of Covid could be as much as tackling the waiting list backlog. The Government must resist the temptation to pick and mix funding for Covid and for the backlog – patients need both.”

Ms Charlesworth is due to appear before MPs on the Health and Social Care Committee on Tuesday to discuss the foundation’s analysis.

The session will also hear from the presidents of the royal colleges of surgeons, physicians and emergency medicine, as well as patients whose medical treatment was delayed as a result of the pandemic.

Saffron Cordery, deputy chief executive of NHS Providers, said the Health Foundation’s analysis reinforces its own warning “that millions of patients are at risk of facing further pain and delays for their treatment if the Government fails to acknowledge the full scale of the impact of Covid-19 on the NHS”.

Last week, a joint report from NHS Providers and the NHS Confederation said the health service budget must increase by around £10 billion next year and claimed anything less could see trusts forced to cut services.

Copyright (c) PA Media Ltd. 2021, All Rights Reserved. Picture (c) The Health Foundation.