The number of people referred to hospital this year has fallen by one third, with almost five million fewer people referred for cataract, hip and knee operations and other types of surgery. 

Experts warned of a “rising tide of unmet need” with millions of people left in pain, or with worsening eyesight, because they had not received the care they needed, as lockdown set in.

The analysis by the Health Foundation shows there were 4.7 million fewer people referred for routine hospital care between January and August 2020 compared with the same period in 2019.

The charity said the figures suggest that the number referred for consultant-led, routine hospital care has fallen by 34 per cent, compared with last year.

Its experts said the figures reflected a reluctance among some patients to seek care, while GPs were unable to refer cases to some services which were suspended during lockdown.

They said the NHS would need to plan for a major spike in demand, on top of the 4.2 million already on waiting lists. 

Tim Gardner, one of the report’s authors, said: “While the NHS is rightly focused on the urgent task of fighting Covid-19, there is meanwhile a rising tide of unmet need which will have a significant impact on people’s health if a sustainable solution is not found.” 

“The NHS made significant progress towards fully reopening services after the first peak of the pandemic, but there is still a potentially huge hidden backlog, as the health service is undertaking far fewer routine procedures compared to last year.”

The Senior Policy Fellow said “radical interventions” would be needed to avoid prolonged delays for those who have not even been put on waiting lists.

The charity said more use should be made of the independent sector, with the creation of dedicated diagnostic hubs and surgery centres. 

Previous research has suggested that Britain’s Covid crisis could lead to an extra 35,000 cancer deaths a year. Medics have raised concerns that lack of screening, late diagnosis and delayed access to life-saving treatment during the pandemic will mean extra deaths for many years to come.

Last week, a study by the Institute for Fiscal Studies found one in six people over the age of 50 had hospital treatment cancelled during the pandemic.

The new figures show that between January and August of this year, the numbers referred for trauma and orthopaedic appointments – such as hip and knee operations – fell by 42 per cent, a drop of more than 622,000 people.

Meanwhile, the numbers sent for ophthalmology appointments, such as cataract surgery, fell by 41 per cent,  representing more than 531,000 fewer people. The same period saw the numbers sent for care from neurosurgery departments fall by 29 per cent, while those sent for urology appointments dropped by 28 per cent.

Professor Neil Mortensen, President of the Royal College of Surgeons of England, said: “Suspending elective surgery during the first wave of Covid created an enormous backlog of operations, in a system which was already overstretched.

“Although frontline staff made huge efforts to get surgical services going again over the summer, it has been impossible to catch up. The latest published NHS data showed that in August 2020, more than 100,000 people had waited longer than a year for treatment.

“We now face a challenging few months, with looming winter pressures, so every option must be fully explored to keep planned surgery going. This includes using the independent sector to create additional beds and theatre capacity, as suggested by the Health Foundation.  

“Looking ahead to next year, we must establish a clear plan for the full recovery of surgery, with the money, staff and hospital facilities required to eliminate the backlog. 

“People understand that this year it’s been very hard to stop waiting lists from getting longer. But now, with expanded testing capacity and a vaccine looking imminent, we cannot accept that the ‘new normal’ means waiting a year for an operation.”

An NHS spokesperson said: “At the height of the first peak, some people chose to postpone care, but the latest figures show that hospitals are carrying out more than a million routine appointments and operations every week and the NHS message to the public has always been clear – do not delay, help us to help you by coming forward for care.

“Keeping the virus under control is key to being able to continue all routine care so it is vital that everyone plays their part by following the government guidance.”

Tracey Loftis, head of policy and public affairs at Versus Arthritis, said those waiting for “life-changing surgery” such as hip and knee operations were being left in excruciating pain even before joining the waiting list. 

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