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Our Action Plan for England

A New Deal for Surgery

A New Deal for Surgery


The COVID-19 pandemic has had a devastating impact on NHS surgical services in England. All elective (planned) surgery was cancelled in the first wave and many surgical teams were redeployed to help treat COVID-19 patients. Latest figures show the largest ever recorded NHS waiting list in England of 4.95 million people, including more than 430,000 waiting over a year. In addition, there is a ‘hidden waiting list’ of people who have not yet come forward or who have not yet been referred for hospital treatment. Estimates vary, but could mean the waiting list growing to a figure of 9.7 million by 2023/24.

Our report, New Deal for Surgery, highlights the challenges that exist and provides recommendations for recovery.

Key recommendations

  1. Continue the £1bn annual ‘Elective Recovery Fund’ for England for a further five years to tackle the elective surgical backlog.
  2. Publish an annual report setting out the Government’s response to the elective backlog in England.
  3. Ensure all Integrated Care Systems (ICSs) urgently consider what measures can be put in place to support patients facing long waits for surgery, including the best and most efficient use of new technologies to support this.
  4. Adopt a long-term aim to increase the number of hospital beds from 2.5 to 4.7 per 1,000 people, in line with the OECD average.
  5. Build NHS capacity to reduce our reliance on the independent sector in the event of future pandemics or crises.
  6. Consolidate COVID-light sites in every region: ensure at least one NHS hospital acts as a COVID-light site in each ICS, with more than one site in larger ICSs
  7. Widen adoption of the ‘surgical hub’ model across England for appropriate specialties, such as orthopaedics and cancer.
  8. Adopt a long-term aim to increase the number of doctors (including anaesthetists and surgeons) from 2.8 to 3.5 per 1,000 population, in line with the OECD average.
  9. Publish a regular assessment of healthcare workforce projections and requirements.
  10. Enable surgical trainees to catch up on missed training opportunities as soon as possible with bespoke programmes of training that include enhanced theatre time.
  11. Introduce statutory regulation for surgical care practitioners to enhance their role and attract more people to the profession.
  12. Continue to ensure that staff wellbeing and retention is at the forefront of plans for elective recovery; all trusts to support less than full time working for surgical teams.

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