Covid: 4.6m people missed out on hospital treatment in England in 2020 | NHS

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More than 4.5 million people missed out on hospital treatment in England last year due to the disruption to the NHS caused by Covid, with growing numbers turning to crowdfunding to pay for cancer drugs and operations.

The number of patients having planned surgery such as a joint replacement plummeted from 16.62 million in 2019 to just under 12 million last year – a drop of 4.64 million people – an analysis of NHS hospital activity by the Health Foundation reveals.

The fall was mainly caused by hospitals suspending many of their normal services as they focused on the influx of people severely ill with coronavirus, which resulted in operating theatres being turned into makeshift intensive care units and surgical staff being repurposed to fight the pandemic.

At the same time GPs referred 6 million fewer people to have diagnostic tests and treatment in hospital as a result of the disruption to care, patients’ reluctance go to hospital in case they caught Covid and a desire not to add to the pressure on the overstretched NHS. They referred 14 million patients in 2020, compared with 20 million in 2019.

It has created millions of “missing patients” who could send the overall NHS waiting list soaring from its already record high 4.6 million people to 9.7 million by 2024 if three-quarters of those people belatedly seek treatment now that the pandemic is easing, the Health Foundation estimates.

Data collected by the website GoFundMe shows that more and more people are turning to crowdfunding to finance urgent medical care as they battle delays, clinical trial cancellations and long waiting lists for NHS care.

The number of people seeking donations from the public citing “waiting lists” as a reason has gone up 87% between last year and this year and the number who mention “clinical trials” – medical research studies that aim to find better treatments, many of which were suspended during the pandemic – rose by 60%.

There was also a 55% surge in people seeking public support mentioning cancer drugs between March 2020 and February 2021, GoFundMe said.

Tim Gardner, a senior policy fellow at the Health Foundation, said a combination of long delays for care and the sheer number of people awaiting care could coalesce into a major political problem. The number of people forced to wait more than a year for their operation has rocketed from 1,613 before the pandemic to 304,044 in January this year, and more than 1 million people have been waiting at least six months, even though 92% of patients are supposed to be treated within 18 weeks under the referral to treatment scheme.

“The waiting list is already at the highest level it’s been since comparable records began in 2007, and if it did rise from 4.6 million now to 9.7 million by March 2024 as we estimate, that’s more than double the waiting list now,” said Gardner. “These ‘missing millions’ have the potential to become problematic for the government. So this – addressing the backlog of care and getting waiting times back on track – has got to be seen as the defining challenge between now and the next general election.

“However, doing that will take years. I think we are looking at well beyond the next election before patients needing care can access the care that they need within the 18-week commitment in the NHS constitution. NHS staff are exhausted, so I think progress towards tackling the backlog and getting things back on track will be slow.”

Rachel Power, the chief executive of the Patients Association, said: “The disruption to NHS services brought by the pandemic appears to have accelerated a trend that was already emerging for patients to use crowdfunding to seek the treatment they could not access on the NHS.”

She said the association was “particularly concerned by reports of treatments being cancelled that could be life-saving”, adding that it was “understandable the patients are exploring other avenues”.

The Health Foundation analysed the number of people who had hospital treatment in each month in 2019 and 2020. It found the NHS performed 712,620 fewer trauma and orthopaedic treatments, 396,107 fewer ear, nose and throat procedures and 205,918 fewer oral surgeries last year than the year before.

The analysis also discloses that the biggest fall in the number of people who received planned care in hospital occurred in the north-west, where the number of patients treated fell from 222,741 to 154,487 – a 31% drop. The south-west recorded the smallest fall, but still treated 24% fewer patients.

It also found that disruption to hospital treatment was much more severe in England’s poorest areas compared with its richest. The number of “completed treatment pathways” fell by 9,162 per 100,000 population in the former but by 6,765 in the latter.

The former chief executive of the NHS in England Sir David Nicholson said in a Guardian interview last week that the scale of the backlog of care the NHS was facing was already “truly frightening” and that delays could damage patients’ health.

The Health Foundation’s findings come days after new polling by Ipsos Mori showed that people think “improving waiting times for routine operations” is the most important task facing the NHS, even ahead of the Covid vaccination programme.

Half of respondents cited shortening the wait times for surgery as the service’s key priority, followed by increasing the number of NHS staff (43%), Covid vaccination (41%), NHS workers’ mental wellbeing (38%) and mental health (36%), Health Service Journal (HSJ) reported.

The “gratitude bounce” among the public towards the NHS during the pandemic would not last long now that Covid was in retreat, with people wanting the service to reduce waiting times for surgery as soon as possible, the pollster’s chief executive, Ben Page, told HSJ.

An NHS spokesperson said: “Alongside treating around 400,000 seriously unwell patients with Covid since the pandemic began and rolling out the biggest vaccine programme in health service history, NHS staff also cared for more than 1.3 million patients without Covid during the peak of infections this winter and cut down waiting times by more than a third since last July.

“The NHS has recently published a plan to accelerate the delivery of operations and other services with a £1bn elective recovery fund, with every area of the country being asked to maximise their capacity to provide care for as many urgent and non-urgent patients as possible.”

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Source: The Guardian
Keyword: Covid: 4.6m people missed out on hospital treatment in England in 2020 | NHS

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