NHS waiting lists might not start reducing until March 2024 because patients delayed seeking care over the Covid pandemic, the Government has warned.
A joint report by the Department of Health and Social Care (DHSC) and the Office for National Statistics (ONS) published last month said that an estimated 10 million patients have not come forward for treatment during the pandemic.
It added that if around half of these return for care, waiting lists may not begin going down until March 2024.
The report said: ‘It is estimated that 10 million patients (a small proportion of the 10 million missing patients are patients for cancer diagnosis and treatment) have not come forward for treatment over the pandemic, who otherwise may have.
‘If around half of these missing patients eventually return, then we would expect waiting lists to be reducing by around March 2024.’
The report also found that GP appointments and referrals were ‘resilient’ during the Omicron wave of Covid and that the variant had had ‘no discernible impact’ on them.
However, it said that some ‘missing referrals’ from during the pandemic will ‘likely not return’.
It said: ‘The number of missing referrals, in other words referrals we would have expected to happen during the pandemic if we operated at pre-pandemic levels, is mainly driven by routine referrals. We expect some, but not all of these referrals to return.’
‘There will be missing referrals that will likely not return due to self-limiting concerns, use of private or secondary care, changes in how GPs refer and deaths due to Covid-19.’
It added that ‘it may be the case that some referrals that would previously have been routine are now considered urgent’, leading to a reduction in routine referrals.
And the report said that some ‘missing’ patients may instead be managed in general practice for longer, for example through ‘increased or better usage’ of specialist advice and triage to ‘help avoid unnecessary referrals’.
‘Given increased referral waiting times and backlogs, some patients who would have traditionally been referred to specialist care may now being managed in primary care for longer’, it said.
Meanwhile, the report estimated that more than 100,000 asthma diagnoses could have been missed due to a ‘reduced use of primary care’.
It said there were ‘persistent monthly reductions’ in rates of diagnosis for coronary heart disease, asthma, COPD and atrial fibrillation due to ‘reduced use of primary care’, remote consultations and IPC measures.
It added that the extent of ‘missing new diagnoses’ is unknown, but suggested that an estimated 8% of those with COPD could be undiagnosed.
The report said: ‘Compared to the 2019 average, between March 2020 and December 2021, there are an estimated 107,000 fewer new cases of asthma and 87,000 fewer cases of COPD.
‘This corresponds to a missing prevalence (as a % of estimated prevalence in December 2021) of 1.5% for asthma and 8% for COPD.’
The report also revealed that more than one in ten referrals from a GP to a long Covid clinic is rejected for being clinically inappropriate.
It comes as the latest official figures show that the number of people waiting for elective care is now estimated to be 6.9 million patients.