As the country edges its way back towards normality, many doctors fear the NHS will take years to recover. According to our 10th survey of members, the majority of doctors (59%) say it will take at least 18 months to get the NHS back on an even keel, including almost a third (30%) who say the huge backlogs in care resulting from the pandemic will take more than 2 years to clear.
Delays in care are particularly acute within certain specialist areas of medicine such as gastroenterology, in which three quarters of specialists (75%) think backlogs will take over a year to clear, including almost half (48%) who think it will take over 18 months. Other specialties where physicians expect it to take over a year to return to ‘normal’ include dermatology (82%), rehabilitation medicine (67%), respiratory (59%), oncology (58%) and cardiology (52%).
Backlogs are exacerbated by continuing delays for diagnostic testing. Clinical physiology is the worst affected, with 87% of respondents to the survey experiencing delays for outpatient tests and 73% for inpatients. Access to endoscopy testing is also difficult – delays in outpatient tests were reported by 82% of doctors while the figure was 64% for inpatients.
Staff wellbeing is suffering, with over two thirds (69%) reporting feeling exhausted and 31% demoralised. Only 57% of doctors say they are getting enough sleep. Two thirds said there had still been no discussion in their organisation about time off to recuperate. Even for the 29% who had had time off, 59% still felt tired afterwards and only 27% refreshed and ready to return.
When asked what impact the pandemic had on teamwork, a third (33%) thought it had a negative impact during the first wave. Two fifths thought it then worsened during the second wave. The top reasons given for that were the pressure they were under (74% in the first wave and 82% in the second) and not enough staff (64% in the first wave and 68% in the second).
This is further evidence that an increase in the medical workforce is needed to ease the pressures that doctors, and the NHS, are under due to a lack of staff and the changing population. The Office for National Statistics projects that the number of people aged 85 years and over is set to double from 1.6 million in 2018 to nearly 3 million in 2043. As it takes 10-14 years to train a doctor, the number of medical school places should be doubled now so that we have more doctors to manage that increased demand. The forthcoming health and care bill must establish greater accountability and transparency on training the right number of people now to meet clinical demand in future.
Professor Andrew Goddard, president of the Royal College of Physicians, said: “Doctors are rightly concerned about the length of time it will take to deal with the enormous backlog of non-COVID care that has built up over the pandemic. We know our patients are waiting for treatment, and in many cases have been waiting for some time already.
"The problem is workforce. Vacancies were high going into the pandemic – we simply don’t have enough doctors to meet demand which is why we need to expand the workforce. We need to double the number of medical school places and establish transparent processes to ensure we are training enough people now to meet future demand.”
Eddie Kinsella, chair of the Patient and Carer Network at the Royal College of Physicians, said: “Attention must now focus urgently upon those patients whose important healthcare requirements have effectively been placed on hold during the last year. The Patient & Carer Network knows that the crisis has had a terrible impact upon many individuals and their families, both in terms of their physical and mental wellbeing. Many patients with serious conditions have endured lengthy waits for treatment, despite the remarkable efforts of NHS staff during this period.
“It is essential that a clear plan is produced urgently to address the backlog of cases, matched with appropriate resources. New, innovative ways of working will help but such a plan must address the long-standing issue of workforce shortages. It would be folly to assume that exhausted clinical staff can simply add to their existing workload in a safe manner.”