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Most deprived areas in England have fastest growing waiting lists, says think tank

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2373 (Published 27 September 2021) Cite this as: BMJ 2021;374:n2373
  1. Elisabeth Mahase
  1. The BMJ

People in England’s most deprived areas are nearly twice (1.8 times) as likely to experience a wait of over a year for hospital treatment than those in the most affluent areas, the King’s Fund has warned.

The analysis, which looked at waiting lists in July 2021 for planned hospital treatment—such as knee and hip replacements, cataract surgery, and other common procedures—found that 7% of patients on waiting lists in the most deprived areas of the country have been waiting at least a year for treatment, compared with 4% in the least deprived areas.

Waiting lists for elective care in general are growing more quickly in deprived areas. Between April 2020 and July 2021, waiting lists grew by an average of 55% in the most deprived areas, compared with 36% in the least deprived areas.

Responding to the findings, NHS Providers deputy chief executive Saffron Cordery said, “It’s vital that in tackling the care backlog, emphasis is given to deal with disparities in access and outcomes for disadvantaged people living in the most deprived areas. Through their work in local systems, trusts are taking on a growing role in tackling these inequalities, but they will need support to do this, recognising that it could impact on broader efforts to reduce the size of waiting lists.”

King’s Fund chief analyst Siva Anandaciva said, “The government’s forthcoming plan to tackle the backlog of care must include a strong focus on tackling health inequalities and avoid a one-size-fits-all approach, otherwise there is a real risk that patients from our most deprived communities will continue to wait the longest for the treatment they need.”

Healthwatch England also commissioned a poll of 1600 adults waiting for planned treatment or who have a relative who is waiting. Almost half of the respondents (48%) didn’t receive any support to manage their condition during their wait and around two thirds (64%) had not been given a contact they could turn to while waiting for treatment.

It also found that 57% of those whose treatment has been delayed agreed this was taking a toll on the level of pain they faced and 54% agreed that their mental health had been affected. Meanwhile, nearly one in five (18%) said they had already gone private for treatment or were considering it.

Based on feedback from the public, Healthwatch England has set out several recommendations for NHS England, including that people should be given personalised communications relating to their position on the waiting list and the next steps for their treatment, as well as a point of contact for advice and support.

Interim support such as physiotherapy, pain relief, and mental health support must also be provided, as well as the ability for people’s position on the waiting list to be changed if their situation changes.

Healthwatch England chair Robert Francis said, “Managing delays should not be a one off transaction. People need an ongoing relationship which minimises the risks and stress of waiting. The extra investment into elective care should be welcomed, but we won’t tackle the backlog overnight. As millions continue to wait for treatment, we can take steps to give people confidence they haven’t been forgotten, which is critical when you’ve been suffering in silence for months.”