The government has set out a new blueprint to tackle the Covid-19 care backlog with campaigners calling for hospital trusts to prioritise people with a learning disability for elective treatment.

The new ‘Delivery plan for tackling the COVID-19 backlog of elective care’ aims to give patients greater control over their own health and offer greater choice of where to get care if they are waiting too long for treatment.

Teams of specialists will be deployed to help patients prepare for their operation, and groups of clinicians and teams will be able to get instant access to test results, offering patients faster clinical advice.

The NHS has also said it will increase capacity to deliver more procedures and scans in the next three years, to around nine million more tests and checks by 2025.

The news comes as figures show that even before the outbreak of Omicron, waiting lists reached 6 million with over 300,000 patients waiting longer than 52 weeks.  

Barriers to healthcare

Mencap said this backlog is incredibly worrying, particularly for people with a learning disability who faced serious barriers accessing healthcare even before the Covid-19 pandemic.

Dan Scorer, Head of Policy and Public Affairs, said: "We already know that breast cancer screening rates for women with a learning disability have been worryingly low for many years - and we’re concerned about how Covid will continue to create barriers for a group who were already at high risk of health inequalities. 

“Before the pandemic, people with a learning disability were already twice as likely to die avoidably and died far younger than the general population. Earlier this year one hospital trust decided to prioritise people with a learning disability for elective treatment after analysis showed they were disproportionately affected by lengthy waits for care.

"We urge other trusts to follow their lead, which could be done through using the GP Learning Disability Register which we are encouraging everyone with a learning disability to join.”

The NHS is working hard to prioritise patients with the greatest clinical need

As part of the plan, more than 100 diagnostic centres will be rolled out and new surgical hubs will be added to the network of 122 already operating across the country, helping ensure that unless people chose to postpone, the longest time patients could wait will reduce so that by March 2025 patients aren’t waiting longer than a year for surgery.

The plan, developed with Royal Colleges, patient groups and health charities, sets out how the NHS staff will make the best use of additional government funding to begin to address the Covid backlog.

Alongside existing clinical standards for urgent and emergency care, mental health, cancer and planned care, the plan aims to:

  • Eliminate waits of longer than a year for elective care by March 2025
  • Aim for no one will waiting longer than two years for an elective treatment by July 2022
  • Aim to eliminate waits of over 18 months by April 2023
  • Three quarters of patients who have been urgently referred by their GP for suspected cancer will be diagnosed, or have cancer ruled out within 28 days.
  • Deliver around 30% more elective activity by 2024/25 than before the pandemic, after accounting for the impact of an improved care offer.

Matthew Taylor, chief executive of the NHS Confederation said: “Health leaders will welcome the national commitment to tackle the backlog of elective care. The NHS is working hard to prioritise patients with the greatest clinical need, including by carrying out 1.3m consultant-led treatments in a single month and we have seen some brilliant examples of innovation where data and technology have been used to both support patients and ramp up activity.

"While the NHS will continue to do everything it can, at least six million people are known to be on the waiting list and so, we need continued honesty about the scale of this challenge, particularly as coronavirus has not disappeared”.

Health disparities should be acknowledged in the plan

Some health groups think that the plan needs to go even further and acknowledge health disparities between different parts of England and groups of people, such as those with a learning disability.

Tim Gardner, Senior Policy Fellow at the Health Foundation, said: "The plan is realistic about the scale and complexity of the challenge, particularly the unknowns of how demand will bounce back and the future path of the pandemic. It’s clear that long waits will be with us for a while to come so a commitment to help patients ‘wait well’ and prepare for surgery is welcome. Support will also be needed for services outside hospitals, including social care, to ensure they have the necessary resources to recover. 

"While the plan is a step forward, it needed to go further. Notably, it acknowledges the disparities between different parts of England but there is a lack of concrete and targeted action to address them. Over 1 in 10 of those waiting in Birmingham and Solihull have already waited over a year, compared to just 1 in 100 in South West London and Surrey. 

"The main factor limiting progress on addressing the elective backlog and the wider recovery is longstanding staff shortages. Failing to come forward with a long-term workforce plan will undermine efforts to bring down waiting lists and put the NHS’s recovery at risk."