Plans to tackle the “catastrophic impact” of the Covid pandemic on patients in England waiting for NHS treatment could be derailed by emergency care demands and a lack of staff, MPs have said.
With about 6 million people already waiting for planned treatment, the backlog caused by the pandemic is a major and “unquantifiable” challenge as more people seek care, according to the cross-party health and social care committee.
A record number of 999 calls and long waits to be seen in A&E, coupled with an increase in the number of people waiting for planned care could result in an “entirely predictable staffing crisis” as burned-out staff quit the NHS.
In its report, the committee calls for a wide-ranging national health and care recovery plan encompassing emergency care, mental health, GPs, community care and social care.
The committee chair, Jeremy Hunt, also called for short-term measures to tackle the crisis.
“We need to go a lot further. We’ve got 6 million people on the waiting list, we’ve got a crisis in our A&E departments, a record number of 999 calls, double the referrals to children and young people’s mental health in some areas,” he told the BBC Radio 4 Today programme on Thursday.
“We don’t have […] a workforce plan that says how we are going to get these 4,000 doctors, and unless we do that we’re going to find this incredible frustration from taxpayers’ point of view that they’re putting the money in but they’re not getting the results out that they were promised.”
The report states that of the 5.8 million patients who were waiting to start treatment in September 2021, 300,000 had been waiting more than a year and 12,000 more than two years.
MPs said government promises to carry out 9m extra checks, scans and operations would not be deliverable “without better short and long-term workforce planning”. The report noted that there were 93,000 vacancies for NHS positions and “shortages in nearly every specialty”, while there were 105,000 vacancies and a turnover rate of 28.5% in social care.
Although the health secretary, Sajid Javid, had promised a plan would be produced by the end of November 2021, the report said NHS England had yet to publish details.
“We remain unconvinced there are sufficient plans for recruitment and retention of staff,” said the report.
MPs had previously called for short and long-term workforce projections, but plans to enshrine the requirement in law had been voted down by the government, and without that information it was “impossible for anyone” to know if enough doctors, nurses and care staff were being trained.
“This creates a gap between ministerial rhetoric about supporting frontline staff and refusal in practice to do the biggest single long-term change that would relieve the pressure they face,” the MPs said.
While use of the private sector to tackle the backlog was broadly welcomed, the report noted that it risked exacerbating existing health inequalities, as private hospitals tended to be in more affluent areas, whereas waiting lists were biggest in more deprived areas.
The report warned against a target culture which could compromise quality and patient safety, and the efficacy of encouraging people to call 111 for urgent but non-life threatening medical need as no evaluation had been carried out.
Dr David Wrigley, the British Medical Association’s deputy council chair, said the report exposed the “gargantuan challenge” facing the NHS.
“The biggest barrier to tackling the backlog caused by the pandemic is a severe staffing crisis and our calls for improved workforce planning have thankfully been heard. It’s now time for the government to listen too.”