Health and Social Care Committee MPs have called on the the Department of Health and Social Care to work with NHS England to produce a broader long term national health and care recovery plan by April to cut record wait times.
The committee also emphasised the importance of the government creating a full and public workforce plan for the NHS but was cool on the impact that independent and private healthcare could have.
The calls feature in the committee’s Clearing the Backlog report published this morning which found that current elective recovery plans are being threatened by pressure on emergency care amid a record number of 999 calls and waiting times in emergency departments at record levels.
The committee concluded that tackling this backlog is a major and ‘unquantifiable’ challenge and consequently called for a broad national health and care recovery plan to include mental health, primary care, community care, and social care as well as emergency care.
The report also found better workforce planning was a central factor in recovery plans but also notes government reluctance to change the Health and Care Bill that would have required publication of an independent assessment of workforce numbers at least once every two years.
According to the committee, without this change it will remain impossible to know whether enough doctors, nurses or care staff are being trained.
The committee also said that while a focus on waiting lists was understandable, a numerical target driven approach risked jeopardising equally important areas of care that kept people healthy and out of hospital.
The committee’s report also contains a recommendation for NHS England to complete and publish evaluations of NHS 111 call first services as soon as is practicable, including learning from those evaluations and the implications for any future iterations of the service.
There is also a call for NHS England to publish, before the end of this financial year, a long Covid plan covering the period until 2023.
The committee added that this plan must be developed in consultation with a wide range of stakeholders, including patient groups and that NHS England should integrate this into its wider health and care recovery plan, as long Covid is likely to have implications for demand and workforce across a range of services.
Predictable staffing crisis
Commenting on the report’s findings, Health and Social Care Committee chairman Jeremy Hunt MP said: “The NHS faces an unquantifiable challenge in tackling a backlog of cases caused by the pandemic, with 5.8 million patients waiting for planned care and estimates that the figure could double by 2025.
“However, our report finds that the government’s recovery plans risk being thrown off course by an entirely predictable staffing crisis. The current wave of Omicron is exacerbating the problem, but we already had a serious staffing crisis, with a burnt-out workforce, 93,000 NHS vacancies and no sign of any plan to address this.
“Far from tackling the backlog, the NHS will be able to deliver little more than day to day firefighting unless the government wakes up to the scale of the staffing crisis facing the NHS, and urgently develops a long-term plan to fix the issue.”
Gargantuan challenge
Also commenting on the report, Dr David Wrigley, deputy council chair at the British Medical Association, said: “This wide-ranging and detailed report clearly lays out what a gargantuan challenge the NHS faces. The biggest barrier to tackling the backlog caused by the pandemic is a severe staffing crisis and our calls for improved workforce planning have thankfully been heard. It’s now time for the government to listen too.
“The report recommends that the government publish an independent assessment of workforce numbers at least once every two years which we have repeatedly called for. Regular, detailed and public health and care workforce assessments must be made available to include modelling of current and future workforce supply, and population and patient need. It’s only with this kind of transparent and open forecasting that the NHS has a realistic prospect of both recruiting and retaining enough staff to provide the required levels of care in the long term to adequately and safely staff the system.
“We’re also pleased to read how the Health and Social Care Committee has dismissed numerical target-driven approaches, which include setting targets for remote and face-to-face GP appointments. All doctors must be trusted to respond to individual patient need and not be driven by arbitrary bureaucracy. And our calls for honest communication and a commitment to keeping in touch with patients have also been heard, with the report stating that no patient should feel ‘abandoned’ by the NHS, even if their waiting times are extremely long.
“The report also correctly highlights that NHS 111 services have not been utilised to their full potential, and we would echo the call in the report for NHS England to complete and publish an evaluation of NHS 111 call first services as soon as possible, and learn from the findings. We also support the calls for NHS England to significantly invest in digital and tech, including an urgent improvement to basic infrastructure, as this would lead to a potential increase in the NHS’s capacity in both the immediate and much longer term.
“The immense challenges facing the NHS this winter means it’s even more important that doctors and all frontline and clinical staff can devote their time, energy and expertise to the delivery of care and must not be expected to participate in non-essential or back-office programmes. We need to keep our talented doctors working in the NHS and support them in every way we can including ending punitive pension taxation rules which are driving doctors to retire early, prioritising workforce in all winter funding decisions and supporting doctors’ mental and physical wellbeing. This report is a clear indication that the voice of doctors has been heard but we now need the government to act on these proposals.”