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Some hospital specialties 'may take two years to clear referral backlog'

GPs look set to face problems with referrals to secondary care for a long time, as an audit by the Royal College of Physicians revealed specialties could take up to two years to clear their backlog.

The news comes as GPs are already struggling with an ongoing backlog of secondary care referrals as a result of the past few months' Covid-19 emergency.

The RCP's audit of leaders from 19 medical specialties in England found that:

  • Almost half, including cardiology, gastroenterology and rheumatology, said they expect to be working at less than pre-Covid levels for ‘at least 12 months or more’, it said.
  • Speciality leaders in respiratory medicine and gastroenterology expect it to take two years to 'recover from the backlog' created by Covid-19, while those in cardiology are expecting it to take 18–21 months.
  • Leaders in eight specialties expect to be working below pre-Covid capacity for 'the foreseeable future'. 

Separately, the college also surveyed 25,500 UK members in May, finding that 70% believed it would take over a year for the NHS to 'get back on an even keel', when defined as 'backlogs managed and services stabilised to a "new normal"'.

It also found that over a fifth (22%) of respondents were still redeployed to other areas of medicine due to the pandemic.

According to the RCP, waiting times are further affected by doctors conducting fewer procedures due to the time taken up by infection prevention and control measures such as donning and doffing PPE and cleaning spaces between patients.

Meanwhile, ‘additional activity’ caused by Covid-19 includes ‘ongoing support’ for recovering patients, especially in respiratory, rehabilitation and renal medicine as well as clinical psychology, it said.

RCP president Professor Andrew Goddard said that the NHS needs to be ‘honest’ with patients that ‘things will take longer’ but that it is working ‘as hard as possible to restore services to pre-pandemic levels’.

He added: 'We cannot underestimate the extent of the work that still lies ahead for the NHS workforce, and the very real possibility of further Covid-19 outbreaks and additional waves, which would of course increase the challenge ahead.

'Medical specialities are doing their utmost to keep up with demand, and will need the ongoing support of NHS England the Department of Health and Social Care to get services back on an even keel.' 

Last week, Pulse revealed that GPs in Liverpool were unable to refer for anything other than urgent cancer over April and May, leading to fears around a backlog of referrals in the coming months.

And earlier this month, GP leaders warned that hospitals rendered ‘untouchable’ by coronavirus measures were still rejecting around 75% of referrals and ‘reverse delegating’ patients back to their GPs.

At the beginning of the pandemic, NHS England had acknowledged that there would be reduced capacity in secondary care but said that GPs should continue to refer.

Readers' comments (3)

  • Probably daft question but has the projected recovery time made some allowances for second wave or localised lockdown??

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  • Some hospital specialties had an 18m backlog to start with. If all are cleared, we will be in a better position than we started. Great news!

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  • You have 16 weeks. Then it's November. Do right by your patient and get them referred in regardless. Let managers figure it out. The lawyers and NHS won't back you otherwise.

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