‘Misleading’ to blame NHS crisis solely on Covid-19, new analysis finds

According to a new analysis, only around 20% of the record waiting list for elective hospital treatment can be attributed to the coronavirus pandemic.

Those behind the findings said the NHS was ‘already pushed beyond its limits’ before Covid-19 and concluded it would be ‘misleading’ to blame the current health service crisis solely on the pandemic.

“History of trends in [NHS] key performance metrics paint a picture of a system already pushed beyond its limits before the pandemic”


The report, released today by healthcare think tank Nuffield Trust, finds that if pre-pandemic trends in healthcare had continued, but for the outbreak of Covid-19, the lists current wait times for elective care would be approximately 5.3 million. The waiting list stood at 6.7 million in May 2022.

The total elective care waiting list was growing steadily before Covid-19, from 2.5 million in April 2012 to 4.6 million in February 2020, according to the study.

It concluded that although the health service has returned to near pre-pandemic levels of activity, ‘significantly more elective care will need to be provided’ to meet NHS England’s target of providing 30% more elective activity. by 2024-25 than before the pandemic.

The authors also pointed to steep increases in waiting lists for 15 key diagnostic tests during the pandemic, which reached just over 1.5 million people in May 2022. But they estimated that without Covid-19, the diagnostic waiting list is said to have still reached around 1.2 million in May. .

The number of diagnostic tests carried out each month has returned to pre-pandemic levels, but analysis by the Nuffield Trust has found the growing waiting list shows activity is not high enough to keep pace demand.

He said there was a “worrying sign” that planned testing is around 4% lower than before the pandemic, while unplanned testing is 30% higher.

This suggests that more patients require emergency testing after admission to hospital, the researchers said.

The authors concluded that it would be “misleading” to say that the Covid-19 pandemic is “solely responsible” for the current crisis in NHS services.

“Covid has accelerated the trajectory the NHS was already on and made the size of the NHS backlog less of an unexpected aberration and more of a predictable consequence of the pandemic, for a system where pressures have been mounting for some time.”

They added: “History of trends in [NHS] key performance metrics paint a picture of a system already pushed beyond its limits before the pandemic, with access times and wait times declining gradually but steadily.

“This is a situation that has been significantly aggravated by Covid-19, given the limited capacity available to absorb such a large and protracted crisis in nature.

Patricia Marquis of the MRC. Image credit: Gareth Harmer

“Increased infection control practices, rising levels of illness and staff burnout, and the cancellation of routine care and redirection of staff have seriously limited the ability of the NHS to deliver care. »

The report comes as new data from NHS Digital shows record NHS nursing vacancies in England, which have now reached almost 47,000.

Responding to the findings, the Royal College of Nursing’s director for England, Patricia Marquis, said the report’s “clear message is that the NHS in England was on its knees even before the pandemic and that even without Covid-19, the lists waiting would have increased dramatically”. ”.

“It highlights the mismatch in basic demand, staffing and resources – something our overworked, underpaid and undervalued nursing staff are all too aware of. And because of what patients suffer.

An NHS spokesperson said: “The NHS has treated over 800,000 Covid patients since the start of the pandemic, which has undoubtedly had a knock-on effect on routine services, but a number record number of people are now being treated by the NHS with waits of more than two years all but eliminated, and those waiting more than 18 months already down by more than 20,000 since January.

They added that the “record demand” for ambulances and A&E “inevitably leads to an increase in ‘unscheduled’ tests and procedures”.