The waiting list for NHS treatment could more than double to around 10 million by Christmas, health chiefs have warned.

The combined effects of maintaining social distancing rules, the backlog of treatments and staffing are the challenges facing the service, according to the NHS Confederation.

The body, which represents health and care leaders, says the massive rise from around the current 4.2 million is a realistic scenario, and its projection assumes a second wave of COVID-19 and a lack of treatments or a vaccine pushing up the waiting list.

A faster return to normal, could see the waiting list for hospital treatment increase to around eight million by the end of the year.

In it’s report, the NHS Confederation warns that the health service in England “faces an uphill battle” as it continues to manage thousands of sick and recovering COVID-19 patients while also trying to restart services such as those for cancer, stroke and heart disease.

It will not be possible to simply “switch on” NHS services immediately, health bosses warn in the study and accompanying letter to Prime Minister Boris Johnson.

They project services will operate with much reduced capacity of about 60% because of the need for infection control measures to keep patients and staff safe.

Some staff are so exhausted and traumatised from caring for coronavirus patients that they will need support, they say, and have called for emergency funding, longer-term spending.

They have also called for further assurances on the effectiveness of the Test and Trace programme and guarantees over personal protective equipment (PPE).

NHS Confederation chief executive Niall Dickson said NHS leaders understand the need to ease lockdown and get the country back to work.

“Part of this will involve restarting diagnostic screening, routine operations, outpatient appointments and other care, but we need to do this safely,” he said.

“That is why we need a robust plan, communicated clearly, and to make sure the NHS can prepare safely, protecting its staff, patients and the wider community as it does so.

“The NHS wants to get back to providing these vital services – the virus has inflicted pain and suffering throughout the UK, but we also know the measures to combat it have come at a terrible cost to those who have not been able to access the care, treatment and support they need and to many whose conditions have gone undiagnosed.

“There is a real determination to rise to this challenge, but it will need extra funding and capacity, not least in rehabilitation and recovery services in the community where so much of the coming demand will be felt.”

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