Background to the report

Waiting is a feature of public healthcare systems but must be managed to avoid adverse impacts on patients. The NHS sets performance standards for waiting times for elective and cancer care. Its performance against these was deteriorating before the COVID-19 pandemic and has worsened since it began. Millions of patients’ care was disrupted, meaning backlogs increased.

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The Department of Health & Social Care (the Department) and NHSE&I have already taken some steps to address the increasing backlogs and waiting times. NHSE&I is developing recovery plans and has an additional £8 billion of NHS recovery funding announced in September 2021. Some backlogs are already visible in NHS systems, but others relate to people who did not present for care during the pandemic, known as ‘missing’ referrals.

Scope of the report

This report looks in detail at backlogs and waiting times for elective and cancer care in the NHS in England. It explains how the current increased backlogs and waiting times have arisen, including the impact of the COVID-19 pandemic.

The report sets out:

  • how waiting times performance for elective and cancer care are tracked in the NHS, and how long patients have been waiting relative to the performance standards;
  • the causes of increasing longer waits before the pandemic and the disruption caused by the pandemic; and
  • the steps the Department and NHSE&I have already taken to address the increasing backlogs and waiting times, and the constraints and challenges the NHS faces in making a full recovery.

The NAO intends to follow this report with a second one, which will describe the NHS’s plans to improve this situation and evaluate its early progress.


Publication details

Press release

View press release (1 Dec 2021)

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