NHS could see around 700,000 patients added to waiting lists this winter

As patient waiting lists reach an all-time high, and the challenges of winter draw closer, the NHS is set to face one of its toughest years to date.

Each year, winter draws everyone’s attention to urgent and emergency care (UEC). The aspiration this year is to keep people safe in the home and out of the hospital, prevent ambulances from stacking up outside A&E, avoid admissions and optimise urgent treatment centres to promptly diagnose and discharge.

Historically, the increased demand for UEC services means that Trust energy is diverted from elective care services. This year, elective care is set to be challenged further because we are heading into winter with the largest waiting list we have ever had. This is further compounded by ongoing industrial action from consultants and junior doctors and continuing high staff turnover which further decreases capacity.

Maintaining elective care services

The independent sector can provide effective solutions this winter to insource or outsource additional clinical capacity. Companies such as Xyla Elective Care can provide this integrated solution, and these services are now easier to contract because of the Digital Mutual Aid System (DMAS) framework.

Earlier this year, the Independent Healthcare Providers Network (IHPN) commented on the impact of strikes on NHS performance figures. David Hare, Chief Executive of Independent Healthcare Providers Network, said: “The figures today on waiting times are deeply troubling.

“This is even more the case given the context – coming in the middle of strikes which are almost inevitably going to have the unfortunate impact of causing yet more patients to wait even longer.

“We must leave no stone unturned to ensure every person on the waiting list can be seen and treated as quickly as possible. This includes ensuring every NHS patient is aware of their legal right to choose the best provider for their NHS treatment, including partners in the independent sector.

“We hope that the Government’s much-needed elective recovery taskforce will focus on ways that more NHS patients can be made aware of their rights, to help them to get the treatment they need as quickly as possible, as well as tackling other issues so that more patients can be seen, more quickly.”

The RTT Outlook

A deep dive into the NHS RTT Data for the peak of winter last year (September to March) reveals that the average number of people on an NHS waiting list was 7.1 million, a 55% increase from the same period in winter 2020/21.

For winter 2023/24, a similar increase simply cannot happen. Taking resources and focus away from elective care during the colder months will be detrimental to future elective recovery efforts.

This data also revealed that the increase in patients on the waitlist over the winter period (September to March) increased between 4-14% each year, meaning we could see a 9% increase in that number this year if the right resources are not put in place.

To alleviate the pressure winter brings to the NHS and sustain efforts towards elective recovery, creative solutions and high levels of collaboration with partners in the independent sector should be considered.

Creative solutions

Digital-first outpatient service models and those that encourage cooperation between multiple partners such as community interest groups and the independent sector means that ‘out-of-hospital’ capacity can be established quickly to provide support across an entire patient pathway. These patients can benefit from faster access to a specialist and diagnostics. The benefit is that patients receive specialist care in a timely manner. This also frees up capacity with the acute hospitals over the winter period so that more complex elective activity can carry on.

Virtual wards can also play an important role this winter by supporting patients in their usual place of residence, thus reducing the demand for acute services. Virtual wards are particularly well suited for certain patient cohorts such as those with exacerbated COPD or acute respiratory infection, as they have an increased likelihood of presenting at Urgent Care in winter.

Building trust and relationships

The recent introduction of NHS England’s Digital Mutual Aid System (DMAS) Framework will be a great catalyst in facilitating more successful partnerships between the NHS and the independent sector. DMAS now includes independent sector providers and facilitates both insourcing and outsourcing services.

This means that companies such as Xyla Elective Care can provide an integrated solution this winter, to both insource clinical capacity, but also manage backlogs of patients away from the acute settings to make sure that patients continue to be seen.

By October 2023, it is expected that patients who have waited more than 40 weeks without being offered their first outpatient appointment will be able to initiate a transfer request to another provider.

Acacium Group’s Healthcare Services Director, Nicola Ellis-Webb said: “To maintain the elective capacity of the NHS this winter and in turn avoid the predicted post-winter increase in waiting lists, it is essential that the NHS continues to work in partnership with the independent sector. We have seen some good examples of this and are working in very creative ways currently to deliver digital-first outpatient services in conjunction with community interest groups, primary care and diagnostic partners’’.

Visit our winter pressures page to find out more: xylaelectivecare.com/our-services/winter-pressures