As many as one in six people in England could be waiting for NHS treatment by the autumn as a result of COVID-19 forcing hospitals to run at 60% capacity.
Figures put together by health economists at the Nuffield Trust show that as many as 10 million people will be on waiting lists for NHS treatment before the end of the year.
NHS England is extending its nationwide contract with private hospitals beyond June and into the summer and private healthcare companies could end up providing up to two million NHS procedures a year.
The roll-on impact of the measures on the health insurance industry is causing divided opinion both within the sector and more broadly.
Aside from that, COVID-19 is forcing hospitals to remove beds and redesign buildings to keep patients safe as they restart routine services.
But precautions to minimise infections mean only half the normal number of operations a day can be carried out.
Nigel Edwards, chief executive of the Nuffield Trust think-tank, said it was likely the NHS would experience an overall “relative decline” adding: “We are a country with high-income standards and high-income expectations, but we’ll be confronted with a capacity of something considerably less than we’ve been used to. That will create some very significant tensions.
“In 18 months’ time, people will be looking at the NHS and saying this isn’t quite what we’ve come to expect.”
THREE MAJOR CHALLENGES THAT ARE CHANGING HEALTHCARE IN THE UK FOR GOOD
Nigel Edwards, Chief Executive, The Nuffield Trust
First, the ever-present danger of the disease re-emerging will mean slowing down basic processes and treatments. Without a quick and reliable test, patients needing planned surgery will have to be swabbed and required to self-isolate before planned investigation or treatment, with a further test immediately before. A 20-minute test is being trialled, but even this will slow down the pace at which the system can operate.
Second, living with COVID-19 will have profound implications on the availability of staff. Staff in high-risk categories may need to be removed from frontline duties, further exacerbating the shortages that predated the pandemic. For those that remain, the changes they will have to make to their daily work will be onerous. These changes do not just apply to hospital staff. In many services like dentistry, optometry and much general practice, direct physical contact between the patient and the professional is needed. Dental practices could face financial ruin as they have to don full PPE and clean rooms between patients. GP surgeries have made great strides in introducing more virtual treatment and consultations, but these are not a panacea.
Third, the building and design of many English hospitals makes them woefully unprepared for the kind of infection prevention and control needed in the coming months. The NHS has large numbers of older hospital buildings, which include shared accommodation and narrow corridors. That will make segregating coronavirus and non-coronavirus patients very difficult.
All of these factors, set alongside the staff shortages we already had, and the drying up of international recruitment, are likely to have unpalatable results: long waits for treatment, rationing of care, burnt out and bogged-down staff, and an angry and confused public, increasingly impatient with the health service they have sacrificed so much to protect.
Nigel Edwards’ blog – first published by The Times – is available here.