Urgent plan and key decisions needed, as half of doctors fear non-Covid backlog is uncontrollable

by BMA media team

Press release from the BMA

Location: England
Published: Thursday 4 June 2020

The Government must urgently outline a credible plan for addressing the huge backlog of patients awaiting NHS treatment in the wake of the Covid-19 pandemic, the BMA says today, as a new survey reveals doctors’ deep concerns about being able to manage a surge in demand in the coming months.

The doctors’ union is calling on the Government to be honest about the scale of the task ahead, and to bring together health leaders and staff groups to ensure frontline clinicians are leading discussions on how to prioritise the sickest patients left without treatment due to the redeployment of staff and resources to deal with the Covid-19 crisis.

The latest tracker survey from the BMA of more than 8,000 doctors1 found that more than half (52%) said they were either not very confident or not confident at all in their own department being able to manage patient demand as NHS services are resumed2.

This rise in demand is already being felt on the ground with over 40% of doctors saying it had increased significantly in the past week, with more than one in 10 saying it had already exceeded pre-March levels3.

Worryingly, more than a quarter of doctors said there had been no engagement with them over how to manage the increase in demand in their place of work or local area4.

The BMA believes the following must be priorities for the Government in addressing the NHS backlog:

  • Transparency: Comprehensive data on healthcare demand, population health and workforce must be rapidly collated and published to inform planning in the months ahead. This will include up-to-date data around waiting lists as well as the prevalence of certain conditions and health inequalities.
  • Capacity: The NHS redistributed capacity to care for Covid-19 patients during the peak of the pandemic, but at the expense of other treatments and services. The Government must commit to giving the NHS whatever resources it needs to tackle the backlog as well as the capacity it needs to meet demand in the long-term.
  • Workforce: Additional physical capacity only works if there are staff to provide care – and the system has so far relied on doctors working above and beyond to meet Covid-19 demand. Efforts must be taken to retain, support and protect the valuable staff who have given their all in fighting the pandemic, prioritising their wellbeing and mental health.
  • Learning: Services have been overhauled in the response to the crisis, and the NHS must keep the positive changes for the long-term while ditching unnecessary, outdated systems in other areas. A key element of this will rely on IT functionality5.

Dr Chaand Nagpaul, BMA council chair, said:

“The NHS entered this crisis severely on the back foot. We had record waits for A&E and cancer care, occupancy levels were dangerously high and we were perilously short of staff.

“While healthcare workers rallied around heroically to tackle the pandemic on the frontline, it was a wake-up call to just how under-resourced and underprepared we were.

“Resources were diverted to Covid-19 efforts at the expense of other care and patients.

“The impact on patients cannot be underestimated – with figures earlier this week showing more than 2 million people waiting for cancer care alone, with overall waiting lists projected to hit 7 million by autumn. Meanwhile, ONS statistics this week estimated that, tragically, there have been more than 56,000 excess deaths during the epidemic in England and Wales, with almost a quarter of these not being due to Covid-19 itself.

“Doctors are rightly worried. The care they are able to offer non-Covid patients has worsened because of prioritising those with the virus, and they have little confidence that they can manage the surge in demand to come.

“The Government must be honest with the public about the surge to come and start meaningful conversations with frontline clinicians about how we can, together, begin to tackle the backlog. This will require transparency around capacity and the workforce crisis, and the need to invest in infrastructure that can meet the healthcare needs of patients.

“And while the last few months have been horrific in many ways, we must learn from them. Doctors have embraced new ways of working, including further use of video technology and remote working. A reduction in paperwork, bureaucracy and unnecessary regulation has liberated doctors and allowed them to dedicate their time to seeing patients. We must retain these positive improvements, which of course require systematic changes like guaranteed access to up-to-date IT software and hardware – the lack of which has frustrated healthcare workers for too long.

“Covid-19 has brought with it the worst health crisis in a century. The NHS must not return to its previous perilous state.”

Ends

 

Notes to editors

The BMA is a trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

  1. 8,455 doctors took part in the survey between 26 and 28 May. Results here.
  2. When asked: “How confident are you about your ability to manage patient demand as normal NHS services are resumed?” 19% of respondents said “not at all confident” and 33% said “not very confident” with regard to their own practice or department. For the local health economy, these figures were 20% and 39% respectively, and for community settings 24% and 44%.
  3. When asked: “Over the last week, what change, if any, have you experienced in the level of demand for non-Covid patient care?” 43% said there was a “significant increase, but at lower level than pre-March and 14% said it was “back to pre-March levels”.
  4. When asked: “What engagement, if any, has there been with you in place of work / your local health economy, around how the increased patient demand will be managed as normal NHS services are resumed?” 27% of respondents answered “none”, with 39% saying “some”. Only 9% said there had been “significant” engagement.
  5. When asked which changes should be retained in the longer-term, 79% said “greater use of remote consultations”, 76% said “use of video technology for virtual MDTs (multi-disciplinary teams), clinical team meetings, Medical Boards” and 74% said “less paperwork/bureaucracy”. Meanwhile, 77% of respondents said that IT hardware and 79% said that IT software had limited their ability to provide remote consultations during the pandemic.
  6. Read the recent BMA paper “In the balance: Ten principles for how the NHS should approach restarting ‘non-Covid care’” here.

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