Clear post-pandemic backlogs now or risk higher costs for taxpayer


A week before Rishi Sunak sets out the spending review, a new Institute for Government/CIPFA report reveals how the pandemic has created huge backlogs in elective care, criminal court cases, referrals to children's social care and school learning – and warns that failing to address these backlogs now will push up costs in future.

Published today, the Performance Tracker assesses how nine public services in England – hospitals, GPs, adult social care, police, criminal courts, prisons, schools, children's social care and neighbourhood services – have coped with the coronavirus crisis and what pressures they are expected to face over the next three years. The chancellor has already allocated extra money to help the NHS tackle backlogs, but the new IfG/CIPFA report says the government must consider using the Spending Review to allocate funds to help other key backlogged services.

The report shows that:

  • In July 2021 there were 5.6 million people waiting for elective operations, longer than at any point since at least 2007
  • There were 58,000 criminal court cases waiting to be heard at the end of May 2021. 40% of cases had been waiting to be heard for more than six months at the end of March 2021, compared to 25% at the end of December 2019
  • Local authorities have been unable to identify, assess and support children as quickly as they ordinarily would. There were 252,000 referrals to children's social care between April 2020 and July 2021 – 11% fewer than the average of same weeks between 2017 and 2020
  • At the end of the spring 2021 term, primary school pupils were on average two months behind in reading and three months behind in Maths

Despite government spending an extra £155bn to support public services across the UK in 2020/21 and 2021/22, some services (notably schools and local authorities) did not receive enough money to cover their extra costs and have entered the recovery in a worse financial position. But, after accounting for money allocated to the NHS, defence and overseas aid, social care, schools, and the additional coronavirus spending, the money left for other 'unprotected' public services will be 2.3% lower in real terms in 2022/23, and 1.5% lower in 2023/24, than in 2020/21 – making it harder for staff to address backlogs.

Graham Atkins, IfG associate director and the report's lead author said: "The pandemic threw the government's plans for public services into disarray and none of the services we examine have been able to operate as they did before. There are now quantifiable backlogs in hospitals, GPs, criminal courts, schools and children's social care.

"The pandemic also prompted rapid change in the way many services were delivered and highlighted the gulf between the range and quality of data available in different services. No government can make good spending decisions without understanding how its choices affect the performance of services and impact on people's lives. The government must collect more evidence on how changes adopted during the pandemic have affected service users, and departments should be given the funding needed to continue to monitor how public services perform as the pandemic eases."

Rob Whiteman, CEO of CIPFA, said: "This year's Performance Tracker paints a stark picture: many public services are effectively out of reach for millions of people across England, amid an alarming increase in the cost of maintaining services at current levels. Today's unprecedented backlogs show the immense pressure that COVID-19 has placed on public services over the past year and half, on top of the existing cost and demand pressures felt in previous years.

"While the government's plan for health and social care and recent job support package are welcome first steps, these are separate plans that target separate issues. The pandemic's disruption to services has taught us how to be more digital, how to lower certain costs and perhaps most importantly, the importance of preventative services. A more comprehensive plan – one that transforms services based on the lessons we've recently learned – in addition to realistic levels of further government funding, is critical to getting public services back on track and running sustainably.

"Swift and targeted action by the chancellor at the upcoming spending review couldn't be more important."

Notes to editor

Please contact the CIPFA press office for more information: email or call 020 7543 5787

IfG press office is available at or 0785 031 3791


CIPFA, the Chartered Institute of Public Finance and Accountancy, is the professional body for people in public finance. CIPFA shows the way in public finance globally, standing up for sound public financial management and good governance around the world as the leading commentator on managing and accounting for public money.

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