How can prioritising treatment tackle the backlog in elective care?

As the UK begins to tackle to backlog in COVID-19 elective care, what action should practices be taking?

The UK is still facing a significant backlog in elective care arising from the COVID-19 pandemic. To solve this the NHS has proposed a delivery plan for tackling the backlog in COVID-19 elective care, which aims to eliminate waits of longer than a year for elective care by March 2025 and waits of over 18 months by April 2023.

Clinical urgency, the impact of waiting on individuals and potential inequalities created by waiting for care are all critical considerations for improving overall health outcomes. The NHS intends to prioritise treatment according to clinical urgency and reduce the longest waits by:

• Implementing clinical prioritisation.
• Managing long waiting times.
• Increasing the number of cancer referrals.

Clinical prioritisation 

Practices must establish a consistent approach to ensuring that those with the most clinically urgent conditions are diagnosed and treated most rapidly. Healthcare providers should receive support on how best to prioritise their waiting lists based on individual patient needs to ensure they receive the most appropriate care at the right time. 

To do this, your practice can look to the Clinical Prioritisation Programme for guidance on how to manage waiting lists through prioritisation frameworks for surgery, diagnostics and endoscopy. Additionally, you can establish a set of steps for healthcare providers to check a patient’s condition, establish any additional risk factors and understand the wishes of the patient regarding treatment options. 

Managing long wait times

The number of patients waiting for treatment in the UK is at a record high of almost 7.21m, according to the most recent NHS figures; addressing such long waits is crucial for improving overall health outcomes in the UK.

GPs must ensure their waiting lists are accurate and reflect the needs of the patients, and that they are using available capacity which reflects patient need and that they are developing a network for supporting and addressing the needs of patients who have been waiting a long time for treatment. 

Increasing cancer referrals

The NHS has seen record levels of urgent suspected cancer referrals since March 2021; around one-in-14 of these referrals results in a cancer diagnosis. Maintaining cancer referrals is key to ensuring that patients start cancer treatment as quickly as possible.

To increase cancer referrals GPs must focus on the cancers for which referrals have been slowest to recover – this is particularly important for lung cancer, where overlap with COVID-19 symptoms has led to people presenting to their GPs later, and prostate cancer, where fewer men coming forward has led to significant decreases in suspected cancer referrals.