01 December 2022
A National Audit Office (NAO) report evaluating progress against England’s elective recovery plan has concluded that activity has continued to lag behind pre-pandemic levels.
Responding to the report, BSR Clinical Affairs Committee Chair Dr Zoe McLaren said, “BSR has produced service guidance tools to support schemes such Patient Initiated Follow-up (PIFU) and the Advice and Guidance programme and continues to engage in frequent clinically led conversations with NHSE. However, our clinical community remains sceptical that schemes introduced to help clear the elective care backlog can deliver the efficiencies necessary to improve, let alone maintain, patient outcomes. Our scepticism is borne out in the conclusion of this NAO report which shows activity has still not recovered to pre-pandemic levels.”
The expansion of PIFU and Advice and Guidance is part of NHSE’s plan to recover elective and cancer care by March 2025.
She continued, “The care of patients with chronic diseases was disrupted by the pandemic, but capacity issues pre-date COVID-19. Staffing within the specialty has not met the demand for services for many years, and this has been compounded since the pandemic with increases in retirement, part-time work, and those exiting the profession. We are attempting to catch up on this backlog at a time when unprecedented pressures consume our hospitals.”
Key findings of the NAO report include:
- A majority (62%) of integrated care systems (ICSs) expect to miss the elective activity target in 2022-23, according to regional operational plans.
- Only five out of 42 ICSs report they will be able to meet the target of reducing outpatient follow-up appointments by 25% by March 2023.
- The list of 5.8 million patients waiting for elective care in September 2021 grew to 7 million by August 2022.
The NAO report makes clear that NHSE is simply operating in a context that is more difficult than it allowed for in its planning with both their budget eroded by inflation and continued pressures due to COVID-19.
BSR CEO Ali Rivett said, “BSR wants to ensure our members are best placed to implement programmes that tackle the backlog and recover services and we play an active role contributing to NHSE guidance and creating our resources bespoke to rheumatology. However, these cannot be the only measures the NHS introduces to return services to acceptable levels and proper attention should be paid to the investment and workforce needed.”
He continued, “BSR has met with NHSE and HEE to discuss the long-term workforce plan and made clear our model for the rheumatology workforce. We will continue to monitor the Public Accounts Committee inquiry into this and raise issues around elective recovery and workforce on behalf of our members.”
Read the report