The British Medical Association (BMA) published on 20 January 2021 new activity data for November and December 2020, showing the disruptive impact of the COVID-19 pandemic on NHS care.

The new data suggests that the closure of most non-COVID-19 services in the first wave, paired with changes in patient behaviour, mean the NHS is now facing a significant backlog of non-COVID-19 care, indicating greater problems for the future.

The BMA estimates that between April and November 2020 there were 2.57 million less elective procedures and 18 million less outpatient attendances in comparison to previous years.

Increasing Backlog of Care and Treatment

With more resources being directed towards COVID services and an increase of infection control measures, it’s evident that it will take much longer to work through this backlog of care as it continues to accumulate.

By now, many elective procedures have been cancelled on at least one occasion. Nearly one year on from the start of the pandemic, it’s clear that these same procedures are continuing to be cancelled or deferred indefinitely, adding to the ever-increasing backlog.

Lengthened Waiting Times

The NHS website suggests that the maximum waiting time for non-urgent referrals is 18 weeks. There are of course exceptions to this, such as:-

  • Choosing to wait longer;
  • Delaying the start of your treatment is in your best clinical interests e.g. stopping smoking or losing weight first;
  • Clinically appropriate for your condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures;
  • Fail to attend appointments; or
  • Treatment is no longer necessary.

In July 2020, at its peak, over 2 million patients were waiting longer than 18 weeks for their non-urgent referrals, compared to over 700,000 in December 2019. In addition to this, patients waiting over 52 weeks for their referrals has continued to spike from 1643 in January 2020 to 162,888 in October 2020 – a 9814% increase.

The president of the Royal College of Surgeons has stated it shows the “calamitous impact” of COVID-19 on waiting times.

Emergency Department waiting times rise

Accident and Emergency (A&E) demand decreased to significantly lower levels in April and May 2020. This overall had notable improvements to performance to the four-hour target – a pledge in the NHS Constitution since 2004 for at least 95% of patients who attend A&E to be admitted, transferred or discharged within 4 hours of arrival.

Demand is anticipated to have reduced as a result of less road users and less alcohol related accidents during lockdown, however there is concern that some patients were avoiding care from A&E even when suffering life-threatening symptoms.

Pre-COVID levels returned as lockdown eased, unsurprisingly raising concerns about how A&E departments would cope with increase in demand, paired with new measures of maintaining social distancing and infection control.

The BMA’s published data from December 2020 shows that whilst admissions and attendances remained stable and lower than December 2019 levels, the longer waits have continued to increase and are at higher levels, despite lower demand. In December 2019 there were 2,180,537 A&E attendances with 2,356 patients waiting more than 12 hours from “decision to admit to admission” vs December 2020, where there were 1,475,710 attendances, a 32% decrease, but with 3,745 patients waiting more than 12 hours from “decision to admit to admission.”

Ambulance Handover Delays

Between 4-10 January 2021, 6.5% of all ambulance arrival handovers were delayed by over an hour. BMA reports that no week in the last 3 years has had that many delays over an hour long. It is thought that this is as a result of disrupted patient flow within the hospitals.

We Can Help

If you have suffered delay in your care or treatment, we may be able to help. We of course appreciate the immense pressure on the NHS at this time and acknowledge that this has to be taken into account when assessing matters, and will apply the already well established law to these unprecedented times, when advising you.

Our team are here to talk to you and provide legal advice and guidance.

Call 01522 561020 or email

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