Poorest ‘waiting longest’ for hospital care as NHS backlog takes it toll

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People living in poorer regions of England face longer waits for routine NHS care, according to new analysis.

The NHS has been told by a watchdog to ensure people have “interim support” in place while it tackles the record backlog of care built up during the pandemic.

Analysis from the Health Foundation shows there were 7.5 million fewer people referred for routine hospital care between January 2020 and July 2021 than would have been expected, based on numbers before the pandemic.

People waiting for common treatments such as knee and hip replacements, and cataract surgery have described the pain and mental strain of waiting.

Leading NHS figures and health commentators have expressed concern that inequalities seen across healthcare have deepened significantly during the pandemic.

Despite the efforts of NHS staff during the pandemic, the backlog has grown to 5.61 million people – almost one in every 10 people in England.

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Now new analysis from The Kings Fund health think tank, shared with the PA news agency and Panorama, shows people living in the most deprived areas in England are 1.8 times as likely to experience a wait of over one year for hospital care compared with people from the most affluent.

Seven per cent of patients on waiting lists in the most deprived areas of the country have been waiting a year or more for treatment compared with 4% of those in the least deprived.

And the waiting lists appear to be growing faster in the poorest regions.

From April 2020 to July 2021, waiting lists have grown by 55% on average in the most deprived parts of the country compared with 36% in the richest areas.

The analysis comes as a poll from health and social care champion Healthwatch England showed the toll the waiting list is having on people’s physical and mental health.

A survey of 1,600 people who were either on the waiting list themselves or had a loved one in need of treatment, found that 54% said it was affecting their mental health while 57% said the wait was affecting their physical health.



Almost half (46%), said they or their relatives did not receive enough information, or any at all, about when they can expect their treatment and 64% were not given a contact to turn to while awaiting care.

And 48% did not receive any support to manage their condition during their wait.

Almost one in five (18%) have already gone private for treatment or are considering it, but 47% said that paying for private treatment “was not an option”.

Healthwatch England has set out a series of recommendations to the NHS in England which involve improving communication with people on the waiting list.

It also called on health chiefs to put in place “interim support” for those waiting, such as physiotherapy, pain relief and mental health support.

Meanwhile the NHS should also be responsive to people on the list and re-prioritise treatment if people’s needs change, it added.

Sir Robert Francis, chair of Healthwatch England, said: “With healthcare services forced to prioritise critically ill patients throughout the pandemic, it is a reality that people will be waiting longer for hospital treatment for a while.

“However, NHS England must manage waiting lists better by reducing the risks and inconvenience to patients caused by delays to care, as part of the national action to reduce the backlog.

“People need clear and individualised information from the NHS, such as what the next steps for their treatment or care will be and how long they can expect to wait. They also need to have easy ways to update the NHS about changes in their condition.

“With more emphasis on interim support, such as physiotherapy, pain relief and mental health support, we can make the experience of waiting more bearable and get people ready for surgery.

“Managing delays should not be a one-off transaction. People need an ongoing relationship which minimises the risks and stress of waiting.

“The extra investment into elective care should be welcomed, but we won’t tackle the backlog overnight.

“As millions continue to wait for treatment, we can take steps to give people confidence they haven’t been forgotten, which is critical when you’ve been suffering in silence for months.”

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Siva Anandaciva, chief analyst at The King’s Fund, added: “The pandemic has pushed NHS waiting lists to record levels and laid bare the deep health inequalities in our country.

“It is not a surprise that waits for NHS care vary across the country but the fact that patients in deprived areas are nearly twice as likely to wait a year or more for planned treatment should be a wake-up call for a government that has committed to levelling up the country, and ring alarm bells for MPs in ‘red wall’ constituencies.

“The Government’s forthcoming plan to tackle the backlog of care must include a strong focus on tackling health inequalities and avoid a one-size fits all approach, otherwise there is a real risk that patients from our most deprived communities will continue to wait the longest for the treatment they need.”

An NHS spokesperson said: “While the pandemic inevitably had an impact on non-urgent care, NHS staff made effective use of additional resource – almost halving average waiting times for elective care over the last year.

“Expert clinicians continue to prioritise patients with the greatest clinical need and hospitals should ensure that a point of contact is available to those waiting for treatment, including through Patient Advice and Liaison Services.”