Longer NHS waits linked to more time on benefits in England
NHS England commissioned the work, and the ONS says its modelled estimates should not be read as direct causal effects.
Longer waits for planned hospital treatment in England were associated with more years of benefit receipt in the five years after treatment, the Office for National Statistics (ONS) has said.
The analysis compared actual waiting times with those of 2015-16, the last year the NHS met its standard of treating 92% of patients within 18 weeks. For inpatients, waits above that target were associated with an estimated 38,972 to 60,572 additional person-years of receipt of any benefit over five years. The range covers 29 treatment specialties.
A person-year counts one person receiving benefits for one year; two people receiving them for six months each also make one person-year. The measure therefore reflects how many people are treated as well as the effect on each patient, so the ONS says specialties should be compared as differences in total impact, not in the effect on individual patients.
Trauma and orthopaedics showed the largest impact, at 17,187 person-years over five years, a 7.5% increase. General surgery followed, with 5,485 person-years. Pain management came third, with 3,861.
For outpatients, above-target waits were associated with an estimated 38,396 to 65,598 additional person-years, across 12 specialties. Neurology led, with 13,372 person-years, a 7.2% increase. Cardiology came next at 9,148 person-years, and rheumatology followed at 7,833.
Median inpatient waits were furthest above target in pain management, at 60 days against a target of 42. Cardiac surgery and vascular surgery each had a median of 59 days against a target of 41. In each of the three, the median exceeded the target by 18 days.
How to read the estimates
The ONS also found that treatment itself was associated with a fall in benefit receipt for up to five years, compared with not being treated. Five years after inpatient treatment, the probability of receiving any benefit was 49.3 percentage points lower for cardiac surgery. For thoracic surgery it was 48.2 points lower, and for neurosurgery 44.0.
That comparison rests on a modelled estimate of what would have happened without treatment, based on benefit patterns in the year before, and the ONS says it does not represent an observed group of untreated patients. It said the results are estimates from statistical modelling and “should not be interpreted as direct causal effects”.
The study covered people aged 30 to 59. It could not tell health-related Universal Credit claims from other claims, and it measured whether people received a benefit, not how much they were paid. Patients still on a waiting list at the end of the study period were left out.
NHS England commissioned the analysis to better understand the economic consequences of elective waiting times for individuals and society. The ONS has published a dataset alongside it, with outpatient results and 95% confidence intervals.
