As 2021 comes to an end the challenges and opportunities for recovery will be front-of-mind for many across the health and care system, alongside the ongoing management of COVID-19.

Here we highlight some of our work to understand the scale of the pandemic’s impact and of the recovery challenge ahead. This includes insights on solutions and approaches that might help health and care services to build back better once the worst of the pandemic has passed.

Understanding the facts about the pandemic’s impact on care

In April 2021 we looked at the impact of the second wave of the pandemic on waiting lists for elective care in England. Our analysis identified that as well as fewer patients being treated, 2020 saw 6 million fewer people referred into consultant-led elective care than in 2019. We predicted that the waiting list (already at the highest level since comparable records began) would grow substantially depending on the extent to which these 'missing patients' join the waiting list.

This was followed by six charts in the autumn that delved into the detail of the latest available figures. They showed that while services in every part of England were being placed under enormous strain, the elective care backlog was not evenly distributed across the country, with some areas hit harder and recovering more slowly. 

The REAL Centre’s Waiting for care analysis looked at the impact of the pandemic on the suspension of routine care, asking how this had affected people’s health and wellbeing and what implications this might have for the future. For some conditions, a delay in care could lead both to living longer in pain and a deterioration in their condition. The analysis explores the implications of this using two case studies – hip replacements and diabetes.

Considering how much recovery will cost

Our REAL Centre report, Health and social care funding projections 2021, looked at how much it would cost to clear the elective care backlog. It estimated that it would cost almost £17bn over the remainder of this parliament (up to 2024/25) for the NHS to clear the backlog of people waiting for routine elective care and return hospital waiting times to 18 weeks. 

Importantly, the report highlighted the huge and growing workforce gap facing the NHS and social care in England over the next decade, which will continue to hamper the recovery. It found that by 2030/31, there would need to be a 40% increase in the health care workforce, double the growth seen in the last decade, to meet demand and recover from the pandemic. Alongside this, the social care workforce would need to see a 55% growth over the next decade, four times greater than the increases of the last 10 years.

Sharing insights from improvers about how to clear the backlog

Case studies gathered by Q’s insights team shine a light on the different ways in which front-line NHS teams are approaching work on health system recovery. They share learning from six projects that are helping to urgently address backlogs in care and improve access to services – from using lean improvement methodology to redesign paediatric pathways, to embedding organisational analytical capability to improve flow on inpatient stays. 

A long read from our Improvement team also highlighted practical changes that can improve productivity in services. The work considers how skill mix change, patient activation, improving flow and the use of technology could all help the NHS survive the pressures it faces in the aftermath of COVID-19.

Harnessing technology and innovation to support recovery 

The onset of the pandemic turbo-charged the speed of innovation in the NHS. Harnessing this great leap forward will be key to ensuring that technology and innovation can continue to speed the recovery of the NHS and sustain high quality care in the future. This was explored in our webinar, Tech and NHS recovery – what you should know, and our Securing a positive health care technology legacy from COVID-19 long read. Our Switched on report also considered how increased use of automation and AI presents many opportunities for improving care and supporting the health service.

But the current health technology innovation landscape is fast-moving and complex. To better understand it, we looked at all the programmes run by government and public sector bodies in England that could support the development of health technology innovation in the NHS. We published insights from our mapping exercise in October. 

Seeing pandemic recovery as a unique opportunity to build back better

With the new Omicron variant of COVID-19 putting additional pressure on the health and care system, the challenges continue to grow this winter. However, as we look to the future, it’s clear that in the long term the process of recovery could present a unique opportunity to rethink how health and care improves and develops. 

Our recent webinar NHS recovery – how do we ‘build back better’? explored how the health sector can approach the monumental task ahead, and what lessons can be learned from efforts to reduce waiting lists in the past.

From our briefing on taking a whole-government approach to improving health, to our report on how anchor institutions can support recovery, and our long read on how policymakers can plan better for the long term – now is the time to think about longer term strategies and fresh approaches. 

Find out more

Search all of our work from the year on COVID-19.

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.

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