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Tories will fail to bring down waiting lists before next general election, says IFS

More than seven million people - one in eight - are now on waiting lists in England, NHS figures show. - Jeff Moore/PA
More than seven million people - one in eight - are now on waiting lists in England, NHS figures show. - Jeff Moore/PA

The Tories will not succeed in bringing NHS waiting lists down before the next general election, analysis by the Institute for Fiscal Studies (IFS) suggests.

Last month, Rishi Sunak made cutting waiting lists one of his five priorities, urging the public to judge the Government “on the results we achieve”.

More than seven million people - one in eight - are now on waiting lists in England, NHS figures show.

A wave of strikes has set back recovery repeatedly, with around 150,000 appointments and operations set to have been axed by the time this week’s walkouts by nurses, physiotherapists and ambulance workers end.

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The IFS forecast has now warned that the waiting list is likely to “more or less flatline for the next year” and will “fall only gradually from mid 2024”.

With a general election due by next May, the forecast suggests that the Conservatives could go to the polls without being able to claim a substantial reduction in those waiting for treatment.

Health officials have promised to increase elective activity by 30 per cent by 2024/25 in order to cut backlogs.

But the IFS said that between January and November last year, the NHS actually treated seven per cent fewer patients from the waiting list than it did over the same period in 2019.

'Waiting lists unlikely to fall'

The authors state: “Waiting lists are – in our view – unlikely to start falling rapidly any time soon. Instead, our central expectation is that waiting lists will more or less flatline over the next year, and fall only gradually from mid-2024.”

The IFS said that for waiting lists to start falling meaningfully this year “as the Prime Minister has all but promised”, one of two things would need to happen.

The authors state: “One, the NHS achieves a truly remarkable increase in how many patients it manages to treat.

“Or two, the number of people joining the waiting list for treatment stays unexpectedly low – whether because they do not think they need NHS care or because they are unable to access it.”

An elective recovery plan published by NHS England a year ago pledged to eliminate waits of more than two years for treatment by July 2022, with 18-month waits ended by April 2023, and waits of longer than a year gone by March 2025.

Officials said the NHS would deliver around 30 per cent more elective activity (treatments planned in advance) by 2024/25 than before the pandemic.

Good progress

The IFS said the NHS has made good progress on some of these aims, with the number of people waiting more than two years falling by 94 per cent between February and November last year. However, the numbers waiting more than a year rose by more than a third over the same period, from 300,000 in February to 410,000.

Report author Max Warner said: “To its credit, the NHS has made real progress in its efforts to reduce the number of patients waiting a very long time for care, virtually eliminating waits for care of two years or more.”

But he said efforts to increase the total volume of activity had been far less successful.

“To turn things around, and deliver on the headline ambition of increasing elective activity to 30 per cent above pre-pandemic levels by 2024/25, would require unprecedented double-digit growth in treatment volumes over the next two years.

“That would be more than three times the growth rate in the five years prior to Covid, and looks increasingly unreachable. As a result, it is likely that the waiting list will flatline rather than fall over the coming year.”

Health officials will announce on Wednesday that hundreds of thousands more patients will get treatment at new surgical hubs.

Surgical hubs are separated from emergency services in hospitals meaning tests and operations can continue in one place, largely unaffected by increased pressure in other parts of the hospital, such as covid and flu.

The plans promise 780,000 more operations and appointments in the next two years, at 37 new surgical hubs, 10 expanded existing hubs and 81 new theatres dedicated to planned care

The £540 million plan includes almost 700 beds.

New surgical hubs

Steve Barclay, the Health and Social Care Secretary, said: “We have made great progress in the past year in tackling the Covid backlogs, but too many patients are still waiting too long for treatment.

“These new surgical hubs speed up access to treatment for hundreds of thousands of patients up and down the country - providing 780,000 additional surgery and outpatient appointments.

“Bringing together the skills and expertise of staff under one roof will ensure we keep pace with future demand and rapidly reduce waiting times, getting patients access to vital procedures when and where they need them.”

Sir Jim Mackey, NHS National Director of Elective Recovery said: “It is testament to the hard work of NHS staff that even as they’ve experienced some of the toughest months in NHS history with ‘twindemic’ pressures during winter and continued Covid cases, they have made significant progress in the first year of our elective recovery plan.”

An NHS spokesperson said: “Staff across the NHS have worked extremely hard since the elective recovery plan was published a year ago to virtually eliminate two-year waits for care and as the IFS has rightly pointed out, the NHS is still on course to end 18-month waits, while the overall waiting list dropped for the first time since the pandemic began.

“The NHS continues to deliver on the most ambitious catch-up programme in its history and has made progress despite a very challenging winter with the ‘twindemic’ of Covid and flu, in addition to more than 13,000 beds being filled every day by patients who were medically fit to be discharged.

“NHS England last week set out its urgent and emergency care recovery plan which will boost services, reduce waiting times, and improve patient experience with additional capacity, including 800 new ambulances and 5,000 more sustainable hospital beds – and so it remains vital that anyone who needs care comes forward as usual.”