Areas of deprivation in England have seen waiting lists on average increase by more than half (55.2%), compared to a third (36%) in the least deprived areas, according to research by the think-tank The King’s Fund, with the national average increase at 42%.
As well as having higher waiting lists, patients are also likely to have to wait longer on the lists in areas of deprivation. Although the number waiting more than one year for treatment has increased across England, the King’s Fund analysis showed that 7.29% of those in deprived areas had been waiting longer than a year, compared to 4.02% in the least deprived areas. This means that on average you are 1.8 times more likely to experience a wait of more than one year if you live in one of the most deprived areas.
Commenting on the analysis, Saffron Cordery, Deputy Chief Executive of NHS Providers, noted how important support from central government and local health systems will be to work through the backlog in a way that is tailored to meet the needs and tackle the inequalities within the communities they serve.
“It is deeply worrying that according to this analysis patients in deprived areas are nearly twice as likely to wait a year or more for planned treatment. Trusts are working flat out to maintain and restore services, while keeping people safe and preventing the spread of COVID-19. It is vital that in addressing the care backlog, due emphasis is given to deal with disparities in access and outcomes for disadvantaged people living in the most deprived areas.”
The government set up the Elective Recovery Fund (ERF) in March 2021 specifically to help NHS organisations (trusts and integrated care systems) to cope with the waiting lists. However, the ability of organisations to reduce these waiting lists was dealt a serious blow in July 2021 when NHS England and NHS Improvement made changes to the ERF, which means many organisations are not being paid at the level needed to tackle backlogs..
In March 2021, the thresholds of activity that ICS had to meet to earn money from the ERF was set at 85% of 2019/20 activity, but in July 2021 just three months into the financial year, the NHSE changed the rules to a threshold level of 95% of 2019-20 activity levels.
Now HSJ reports that NHS organisations have lost out on millions of pounds to help them tackle backlogs. HSJ has seen declarations from multiple local NHS organisations confirming they will get either no income or substantially less than expected from the national elective recovery fund.
HSJ reported that when the threshold changes were announced, ICS leaders told it there would be a “financial impact” and accused NHSE of “not just [moving] the goalposts” but “[taking] the entire pitch”.
HSJ reports that South Yorkshire and Bassetlaw ICS, will lose planned income of around £22m, North Cumbria Integrated Care Foundation Trust expects to incur losses of £2m between July and September due to the threshold change, and County Durham CCG said it was missing out on funding after being granted £1.2m for April and May. These are probably just the tip of the iceberg.
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