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On point paper

Hidden health needs – the elephant in the NHS waiting room

Health Life sciences
Dr Jonathan Pearson-Stuttard Partner & Head of Health Analytics

Excessive waiting lists are only part of the problem facing the NHS. People on waiting lists have been referred for treatment, have entered the health system and have not yet received care. They are included in data published by NHS and make up the unmet need that is ‘known’. However, there is also an unquantified, unknown, ‘hidden need’ made up of those who still require treatment for a health condition but have not yet sought care.

The disruption the healthcare system and our day-to-day lives caused by the pandemic has understandably impacted health-seeking behaviour for many who would have come forward for care but chose not to due to the risk of being infected with Covid-19, or who were unable to secure appointments. There are large and persistent geographical inequalities within both the known and hidden waiting list populations.

In this paper, LCP analyses the scale of this total unmet need and looks at what the impact might be of recently announced government pledges on these numbers.

Read the paper


Key discussion points include:

  • Our analysis estimates the total current hidden need to be 7.8 million people across England but, as with the waiting lists, this number is distributed very unequally across regions and smaller areas.
  • LCP predicts that without intervention the level of need is expected to peak at 15.5 million in 2023 and still stand at 13.5 million in 2024.
  • The Government has proposed increasing NHS capacity by 30%. Even under this scenario, the total unmet need levels would still be over 10 million in 2024.
  • The North West of England has been hardest hit. CCGs from the North West accounted for 50% of the top 10 CCGs with the greatest hidden need at 6 months and 18 months into the pandemic
  • Approaches to tackling the backlog must be both data-driven and proportionate to health need to ensure entrenched inequalities in waiting time and poor health while waiting are not a lasting legacy of the Covid-19 pandemic.