Doctors express concern over clearing NHS bottleneck

More than 70% of doctors feel it is unlikely that the NHS will resume a near-normal service by Autumn, a survey by the British Medical Association has revealed.

NHS England is targeting a return to normal levels of activity following the first coronavirus pandemic peak in the next few months, but the survey of more than 3,000 doctors showed that 40% thought this was highly unlikely and 30% fairly unlikely.

A third surveyed also felt that it would take more than a year for elective procedure waiting lists to clear, highlighting the enormity of the challenge in releasing the bottleneck caused by the COVID-19 pandemic.

In other key findings: 60% of doctors said they were not very or not at all confident in their local health economy managing demand as NHS services return to normal; 51% were not confident about being able to manage demand during a second wave of the virus; and 26% of doctors said in the last two weeks non-COVID demand had increased to pre-pandemic levels, with 17% reporting that demand is now even higher than before.

The results “underline the sheer scale of the challenge for the NHS in the coming months, and the anxiety and concern felt by already exhausted frontline doctors as they look ahead to what will likely be one of the most challenging times of their careers,” said Dr Chaand Nagpaul, BMA council chair.

“Although staff are being told that the NHS will begin to return to ‘business as usual’ they have little confidence that it will be able to cope with the backlog of millions of patients left untreated during the first spike of the pandemic. Doctors are worried for their patients and the risk of their condition deteriorating as a result of further delays, given that more than 50,000 patients are already waiting longer than 12 months for treatment – 46-fold the number from a year ago – and 45% of doctors told us they are seeing patients presenting later than before with their symptoms.

“At the same time, doctors are really fearful of how the NHS will cope if a second wave of COVID-19 hits, which could be devastating for the health service if it arrives in winter and amid a potential flu outbreak.

“We must do all we can to avoid another peak now, focusing on prevention, and maintaining clear, consistent public health measures and messaging.”

Rising wait times

The findings come amid new data showing record wait times on a number of key NHS performance indicators, including the GP referral-to-treatment pathway, where the national target is to have 92% treated within 18 weeks but current data show just that is being achieved in just 52% of patients.

Moreover, according to analysis by the BMA, in some areas this figure is even lower: 38% in Dorset, 42% in Mid and South Essex, and 44% in Humber, Coast and Vale.

“The most recent waiting time data speaks for itself, with patients waiting unacceptably long times for treatment. But the Government and NHS England also need to be honest with both healthcare staff and patients about the backlog we’re facing,” Dr Nagpaul added.

“They must produce a clear strategy of how we can manage this increased demand, working with clinicians to prioritise those patients most in need of care, while at the same time being able to continue treating people who are still suffering with COVID-19. And crucially, doctors do not want patients avoiding the health service and risk getting much sicker as a result.”

“As the pandemic continues, we are on a collision course with an extremely difficult winter, with major backlogs of treatment, alongside reduced capacity due to factors like increased infection control, combined with the usual pressures, and the added unknowns such as the likely rates of COVID-19 transmission, and the long-term effects of the virus on patients,” Dr Layla McCay, director at the NHS Confederation, also recently noted.