Access to healthcare – UK Government assessment
Although the NHS is treating more people than ever before, increasing demand has led to an increase in waiting times across many health services, including accident and emergency services, referral to cancer treatment and elective care. The pandemic has intensified many of these challenges, while highlighting existing health inequalities, linked to age, race, disability, sex and socio-economic status. There continues to be very limited data on the experience of people by protected characteristic. NHS England has committed to tackling health inequalities and variations in access to care through its Long-Term Plan, however it is too early to review the impact of these reforms.
- Waiting times across many health services have increased considerably over the past decade. The percentage of patients in A&E that were admitted, transferred or discharged within four hours reached an all-time low of 69% at Type 1 A&E Departments in December 2019. Waiting times for cancer treatment, elective treatment, and diagnostic tests have also increased as well as cancelled operations and delayed transfers of care.
- Rising waiting times are in part due to increasing demand, with the NHS treating more people now than ever before, but long delays mean that more people are unable to access healthcare services when they need them.
- Before the pandemic, there were well-established inequalities in access to healthcare for different groups, including those with learning disabilities, refugees and asylum seekers, transgender people, Gypsies, Roma and Travellers and homeless people.
- Changes to the NHS charging policy in England have restricted access to healthcare for people refused asylum and other groups of migrants.
- It is too early to review the impact of the NHS Long Term Plan, which includes proposals to improve access to health services and address health inequalities.
- A shortage of data that is separated by individual protected characteristic makes it difficult to review the disparities in access.
- As the pandemic has developed, medical staff, facilities and funding have been diverted to address COVID-19 critical care cases. This has had a particular impact on people sharing certain protected characteristics. Concerns have been raised that disabled and older people have faced discrimination and unequal access to life-saving treatment and specific challenges accessing critical medicines and pain-management treatments during the pandemic, while trans people have reported difficulties in accessing healthcare relating to their gender identity.
- In August 2020, Public Health England published Disparities in the risks and outcomes of COVID-19, which found that the pandemic has replicated existing health inequalities and in some cases made them worse. Healthcare inequalities include inequalities by age, race, sex, disability and socio-economic position – additional risk factors include having more than one illness, being obese, working in certain environments (mainly low-skilled roles) and living in an urban area.
- Shortages and delays in sourcing effective Personal Protective Equipment (PPE) during the early stages of the pandemic for people working in health and community health services created risks affecting access to healthcare.
Read more about the UK and Welsh Governments’ actions on access to healthcare.