The NHS is trying to reduce risks from COVID-19 to patients and increase its ability to respond to the crisis, by continuing to treat urgent elective patients, such as most cancer treatments, and deprioritising non-urgent care, with an emphasis on risk management. This should avoid short-term deaths but there will be a longer-term knock-on impact from delaying so many non-urgent services …
We are unable to provide a detailed estimate of the impact of these changes to healthcare activity as it is unclear precisely what activity would be postponed, for how long, what knock-on impact this would have on future patient waits, and how a delay in treatment would affect outcomes. Instead, we have modelled a scenario whereby we assume 75% of elective care activity is stopped for a period of six months. Various evidence supports the estimate that 75% of elective care has been postponed, but it is unclear how long the postponement will be for. This activity represents around £17bn of expenditure over a six-month period. If this activity were cancelled entirely it would result in an estimated 185,000 additional deaths …
This is an upper-bound estimate for this scenario. The NHS will be prioritising life-saving treatments and will be hoping to postpone rather than cancel most of this treatment. However, there will be a knock-on impact on future patients as the NHS takes time to work through the backlog.
If services can be resumed quickly, most of the risk of mortality can likely be managed, but if there are continuing delays for a longer period, there could even be a proportionately greater impact than is estimated here, if long waiting lists build up and have a knock-on impact on future patients requiring healthcare.
