The UK Has a Surgical Backlog Crisis

Healthcare professionals in the United Kingdom are calling for urgent changes to address the UK's elective surgery backlog.

Elective surgery can include surgery that is planned and can be delayed, such as hip and knee replacements, hernia surgery and procedures for peripheral vascular disease, and even transcatheter aortic heart valve (TAVR) procedures.

The "Recovering Elective Care" white paper, published by Mölnlycke, brings together experts from across the healthcare system to examine the state of the elective surgery crisis in the UK, and develop a series of recommendations to drive down the elective care backlog.

With over 7 million people on the waiting list, the elective surgery crisis is now the most significant challenge facing the NHS post-COVID.

“The significant crisis facing us in elective care is a huge threat to our NHS, but it also represents an opportune moment to reconsider how we optimize patients for surgery. By increasing day case procedures, implementing shared decision-making between clinicians and patients, and standardizing best practice across pathways, we can reduce waiting lists," said Scarlett McNally, deputy director at the Centre for Perioperative Care and a consultant orthopedic surgeon professor. "As clinicians, we want to provide the best care we can for our patients – this report sets out recommendations to improve the patient’s experience of surgery, whilst improving efficiency and tackling the backlog to reduce pressure on the NHS.”

The report provides an overview of the scale of this challenge, highlighting best practice across the healthcare system and issuing recommendations to help healthcare leaders to address the crisis. It also provides considerations for future research, suggesting how healthcare, government, and industry stakeholders can work together to embed improvements in the NHS.

The Recovering Elective Care white paper discusses the health service’s learnings from COVID-19, calling for a renewed focus on increasing collaboration among the workforce and protecting staff from burnout. The report also explores how planning for surgeries and investing in innovative practices can support the elective surgery recovery.

Among the recommendations, the report urges the UK government to consider implementing a program to establish dedicated day surgery units and teams. The report also suggests establishing new guidelines to use shared decision-making to prepare patients in secondary care settings, to support surgical teams to adjust elective surgery waiting lists in a way that is reflective of patient need. A national NHS task and finish group should be established to explore the potential for greater implementation of value-based procurement models in reducing the elective surgery backlog, the report also recommends.

“The current backlog in elective care presents the biggest challenge to delivering effective healthcare in the United Kingdom," said Tod Brindle, medical director at Mölnlycke. "Every time a surgical procedure is delayed, it is another patient unable to return to normal life or begin their recovery. In facilitating this report, we at Mölnlycke want to work in partnership with healthcare professionals and experts to understand how we can create a sustainable elective care recovery for the NHS and identify how Mölnlycke can provide the solutions to support this.”