The impact of COVID-19 on the NHS

Even leaving aside the possibility of future waves of the virus, COVID-19 poses new and enduring challenges for the NHS that need to be considered alongside the goals set out in the NHS Long Term Plan – this raises the question of whether a blended system is still appropriate. As the NHS emerges from the pandemic it will need to tackle the backlog of unmet care need, meet new demands for mental health services and treating long COVID, and build resilience for future health shocks. COVID-19 will have major direct and indirect impacts on many dimensions of health service care:

  • Demand: Lengthening waiting lists and waiting times: the postponement of operations and diagnostic activities has created a growing backlog of cases. More than 300,000 people have been waiting more than a year for planned care (compared with around 1,500 in December 2019) and analysis suggests that waiting lists and median waiting times will grow for some time as the backlog of unmet need begins to present for care.
  • Supply: Need for added capacity: the need for infection control requires new capacity to meet demand. Infection control measures have various impacts from the frequency of diagnostics to the use of operating theatres and wards. This will change the costs of delivering capacity such that historical data may not be a good guide to future costs.
  • Demand: Rising mental health challenges: COVID-19 and its associated impacts (such as rising unemployment and social isolation) are leading to increased mental health burdens that will further add to waiting lists. Initial research has documented rising levels of mental distress in the early stages of lockdown compared with pre-lockdown periods.
  • Demand: Managing the longer term health consequences for patients who have had COVID-19: ONS research finds that in May 2021 around 1 million people self-reported living with long COVID, of which around a third first had COVID-19 at least a year previously.
  • Supply: the acceleration and use of new technology.
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