NHS hospital waiting lists could hit 10 million in England this year

The waiting list for hospital treatment could soar to almost 10 million people by Christmas amid a huge backlog caused by coronavirus disrupting services, NHS leaders are warning.

Hospital bosses say that such a massive increase in England is a realistic prospect, given so many people have been unable to have surgery and crucial diagnostic tests in recent months while the NHS’s main priority has been minimising the damage from Covid-19.

The total number of people waiting to undergo a procedure in a hospital in England such as a hernia repair, cataract removal or hip or knee replacement stood at 4.4 million before the pandemic. It then fell to 4.2 million because in March GPs referred fewer patients for care to help hospitals tackle the pandemic and also because some patients were reluctant to risk getting infected by going into hospital.

However, the NHS Confederation estimates that it is likely to reach 9.8 million by the end of the year as a result of staff shortages and hospitals having to cap the number of patients they can treat at any one time because of strict physical distancing rules that reduce the number of beds available.

In a “pessimistic” scenario – which would result if a second wave of the virus emerges – the waiting list, comprising people who are meant to be treated within 18 weeks, could hit 10.8 million. And even under the confederation’s best-case “optimistic” scenario about 8.1 million people would be waiting.

Any of those three totals would be far in excess of the record 4.5m number of people who have ever been on the referral to treatment waiting list, and they pose problems for ministers.

Boris Johnson and the health secretary, Matt Hancock, have made clear that they want NHS services to get back to providing the normal pre-coronavirus range of diagnostic and treatment services as soon as possible now that the worst of the pandemic appears to be over.

But the confederation’s chief executive, Niall Dickson, has warned the prime minister in a letter that, while hospitals are keen to restart services, this will take time, partly because of enforcing social distancing in the NHS and also because many staff are “exhausted and traumatised”.

He said: “It will not be possible simply to ‘switch on’ NHS services.” Dickson cites a number of “operational challenges”, including the need for the new test and trace programme to identify and isolate carriers of the virus to be working well and for NHS personnel to have enough personal protective equipment to be able to work safely while the virus is still circulating.

A Royal College of Nursing spokesman pointed out that the NHS in England was short of about 40,000 nurses, adding: “For burnt-out nursing staff on short-staffed wards, care homes or clinics, it will be a struggle to restart services. The legacy of this pandemic is yet to dawn. The professionals are still focused on the here and now.”

Jonathan Ashworth, the shadow health secretary, said: “Ministers need to take heed of these warnings from NHS leaders now.

“It is inevitable that the Covid-19 pandemic will impact our health service in the months ahead but it is vital that ministers begin to address this backlog of delayed treatment and rising clinical need.”

Steven McIntosh, the director of policy, campaigns and influencing at Macmillan Cancer Support, said action was needed to enable cancer patients to get care.

“Coronavirus has created a ticking timebomb of undiagnosed and untreated cancer in the UK, which is leaving many people living with cancer feeling desperately anxious and alone.

“We need urgent action to address the uncertainty of delayed cancer services and prevent coronavirus resulting in a serious spike in cancer deaths. All UK governments must rapidly restore cancer care and deal with the backlog in treatment whilst keeping staff and patients safe during the pandemic,” he said.

A Department of Health and Social Care spokesperson said: “Thanks to the hard work and dedication of NHS staff, hospitals were not overwhelmed during the peak of the coronavirus outbreak.

“Guidance has already been issued to the NHS on how they should start to restore urgent services in a safe way.”