NHS Waiting lists vastly underestimate the scale of unmet health need in England according to new report ‘Hidden health needs – the elephant in the NHS waiting room’. LCP predicts that without intervention the level of need is expected to peak at 15.5 million in 2023 and still stand at 13.5 million in 2024. Even with the planned government intervention, LCP still projects that health need will be ‘sky high.’    

The analysis also reveals the parts of country that are likely to feel this demand strain more acutely, with recently acquired 2019 Conservative ‘Red Wall’ seats likely to be impacted most.  

While waiting lists show the amount of people currently waiting, they don’t show the true scale because there are many people who have health issues but have not yet come forward for treatment due to the pandemic.  By comparing the difference between monthly treatment referrals in the year before the pandemic with those during the pandemic, LCP has been able to highlight the true scale of unmet need for the health service by combining official data with the expected number of people with ‘hidden health’ needs.  

Health Secretary Sajid Javid has suggested that waiting lists could reach as high as 13 million without further intervention. LCP’s analysis highlights that while current wait lists stand at 5.8 million, there are 7.8 million people in England who are ‘hidden’ meaning that already the true scale of health need is already at 13.6 million.   

LCP has used this data to project what waiting lists might look like over the next few years and has modelled what the impact of government policies proposed to increase capacity by 30% might be Under the scenario of increasing capacity by 30%, the total unmet need levels would be over 10 million in 2024.  

Key findings in the analysis are:

• Government projections of future health need are on the assumption that all those who have hidden health issues will come forward at the same time. This is unlikely to be the case and means that there will be sustained pressure on lists for years to come.   
• By combining people on waiting lists and those with hidden health needs, LCP predicts that unmet need could peak at over 15.5 million people in early 2023 with no interventions. In 2024, expected General Election year, unmet health could be standing at 14 million.
• The North West of England has been hardest hit. CCGs from the North West accounted for 50% of the top 10 CCGs with the greatest hidden need at 6 months and 18 months into the pandemic
• Mapping CCG data to 16 constituencies that were marginally won by the Conservatives in the 2019 General Election, highlights that in every case the number of voters with unmet health need dwarfs the majority in the constituency.

Dr Jonathan Pearson-Stuttard, Head of Health Analytics at LCP, commented: “The large and growing NHS waiting lists is just the tip of the iceberg. The hidden need is likely to be even larger and representing people who will present later and in poorer health than they would have done prior to the pandemic. Our modelling suggests, that even with increased government funding and corresponding plans to increase capacity, unmet health levels could still be sky high.” 

“Our analysis highlights the large variations in unmet need across the country and this type of granular data analysis should be harnessed by government better target this funding and resources proportionately to unmet health need. This could both clear the backlog efficiently, mitigate worsening health inequalities and provide productivity boosts to areas that have been hardest hit.”