MPs have urged the Department of Health and Social Care not to ignore other areas of care in its drive to reduce the backlog of patients requiring routine treatment.
A lack of clear vision, a “predictable” staffing crisis exacerbated by the Omicron Covid variant and pressure on emergency care – with 999 calls and waiting times in emergency departments at record levels – all threaten the government’s plans to tackle huge backlogs that have emerged during the coronavirus pandemic, the Health and Social Care Select Committee said.
With 5.8 million patients waiting for planned care and estimates this figure could double by 2025, the NHS faces an “unquantifiable” challenge in tackling the backlog of cases caused by the pandemic, the committee said in a report today.
The MPs said the department should produce a recovery plan by April which tackles the backlog not only in elective care but also in other areas such as emergency care, mental health, primary care, community care and social care.
MPs also warned against focusing solely on just reducing numbers. A focus on waiting lists, which are at the highest levels since records began, is understandable but setting only numerical targets could risk jeopardising equally important areas of care “that keep people healthy and out of hospital", they said.
‘Predictable’ staffing crisis threatens recovery efforts
The government’s recovery plans “risk being thrown off course by an entirely predictable staffing crisis”, committee chair Jeremy Hunt said.
“The current wave of Omicron is exacerbating the problem, but we already had a serious staffing crisis, with a burnt-out workforce, 93,000 NHS vacancies and no sign of any plan to address this.
“Far from tackling the backlog, the NHS will be able to deliver little more than day-to-day firefighting unless the government wakes up to the scale of the staffing crisis facing the NHS and urgently develops a long-term plan to fix the issue.”
The government has committed to investing £36bn into health and social care in the next three years, which it says will allow for an “extra nine million checks, scans and operations for patients across the country”. But the committee said that without better short and long-term workforce planning, it does not believe the nine million additional checks, tests and treatments will happen.
MPs criticised the government’s resistance to changes to the health and care bill that would have required publication of an independent assessment of workforce numbers at least once every two years.
Without this info on workforce numbers, the committee said it will remain impossible to know whether enough doctors, nurses or care staff are being trained.
The report highlighted “'historically high”' enquiries about mental health and the shortfall of GPs, with plans to recruit 6,000 additional GPs by 2024 “not on track”, according to health secretary Sajid Javid.
MPs also said it was “extremely disheartening” that there appeared to have been no discussion about getting more people into training.
They recommended that the government undertake an urgent review of short-term recruitment and retention issues, to be published before the arrival of new funding early this year.
Clear vision needed and ‘targets culture’ warning
The national health and recovery plan must set out a clear vision for what success in tackling the backlog will look like and what patients can expect their care to look like in their local area in the coming years, the MPs said.
But, they said, in setting metrics for success DHSC must not rely on numerical targets alone and should ensure hidden backlogs are also being tackled and compassionate cultures are being encouraged.
The report warned against fostering a “targets culture”. They pointed to compromises in the quality and safety of patient care that happened “the last time tackling large waiting lists was a political priority”, under Tony Blair’s premiership.
Increasing bed capacity and improving diagnostics
In the 2021 Spending Review, the government committed to invest in increasing bed capacity as part of a £1.5bn package to tackle waiting times for planned care.
The health and social care committee has asked the government to produce an independently verified analysis of how many and what type of extra beds the NHS needs to provide effective everyday care for patients as well as Covid treatment.
This should be accompanied by sustainable, long-term plans to tackle delayed discharges, MPs said.
In addition to providing more funding to clear the backlog, the government pledged £2.3bn to create 100 new community diagnostic hubs for MRI, CT and other checks. The UK is currently in the bottom five in the OECD for numbers of MRI and CT scanners.
The committee has asked for detailed plans on where the hubs will be placed, who will staff them and how they will help to improve services.
The report – ‘clearing the backlog caused by the pandemic’ – is based on evidence given to the committee’s three-month inquiry on the subject last year.