NHS must boost treatment by a fifth to eliminate Covid backlog, researchers say

NHS Scotland must treat at least 20% more non-emergency hospital cases over the next three years to eliminate the backlog caused by the Covid-19 pandemic, according to new analysis.

The number of referrals waiting to be treated in Scotland topped 667,000 at the end of December 2023, covering an estimated 10% of the population, the University of Edinburgh said.

Researchers warned that without any increase in capacity, the waiting list will increase to nearly one million people by December 2026.

Treating an extra 32,300 cases per year over the next three years, however, could clear the backlog, experts suggest.

Researchers conducted a country-wide analysis of Scotland’s healthcare system to estimate the extent of disruption caused by the pandemic and its long-term impact.

The waiting list was found to have risen from 285,000 in 2013 to 386,000 prior to the start of the pandemic in 2019 – a 35% increase over six years.

Covid-19 then intensified the increase, the study found, taking the waiting list up to 668,000 by December 2023 – a jump of 73% over four years.

By the end of 2023, more than half of inpatient and outpatient referrals in most regions were waiting longer than the Scottish Government’s target of 12 weeks.

NHS Borders and NHS Fife were among the worst affected health boards for both inpatient and outpatient referrals, with more than double the number of ongoing cases in 2023 compared with 2019.

Researchers said comparisons between regions should be interpreted with caution, however, as the figures do not account for differences in population demographics.

Dr Syed Ahmar Shah, from the University of Edinburgh’s Usher Institute, who led the study, said: “The NHS’s struggle to meet demand didn’t start with the pandemic – it began years earlier.

“The pandemic accelerated the decline of an already strained system. Recovery efforts so far have fallen short.

“To turn things around, we need meaningful collaboration between the Government and NHS leadership to set realistic recovery plans and ensure adequate funding for their implementation.

“Addressing the current challenges will require a significant and sustained increase in hospital capacity for elective care over several years to tackle the backlog.

“Long-term recovery also demands a holistic approach, including system-wide strategies like better demand management, prioritising cases by clinical urgency, and improving overall efficiency.”

Health Secretary Neil Gray said: “We know we are still feeling the effects of the Covid-19 pandemic which had an undeniable impact on our NHS.

“Despite this we are reducing health service backlogs through new capacity at our national treatment centres and have provided additional funding this year which will deliver 24,000 outpatient and inpatient appointments and over 40,000 diagnostic tests. We are making progress but know there is more to do.

“That is why our Budget, if passed by Parliament, will provide a record £21 billion for health and social care, including £200 million to reduce waiting lists and improve capacity further.

“This will help ensure no one waits more than a year for a new outpatient appointment or inpatient/day case treatment by March 2026. I urge Parliament to get behind the Budget.”