The Nuffield Trust said hip replacement average waiting times in England jumped from around 87 days before 2020 to 180 days in 2020. For the three subsequent years average waits have remained around 128 days, nearly 50% longer than pre-2020. Spain and Finland saw little change in pre and post pandemic, however, while median waiting times increased to a lesser degree following in Norway and Sweden.

For knee replacements, while England average waits rose from around 91 days before 2020 to 209 days in 2020, and in the three years since have remained around 142 days, in Spain, Italy, Portugal and Finland they appeared to be similar to, or shorter, than before the pandemic.  

Average waiting times for cataract surgeries in England, however, improved quicker than almost all other countries. The Nuffield Trust said this was because procedures don't require overnight stays and extensive rehabilitation, so it has been easier to return to pre-pandemic levels, with staffing issues having less of an impact than on orthopaedic surgeries.  

The analysis noted the actual amount of time people wait for treatment on average appears to be shorter in England than in several countries.  

Sarah Reed, Nuffield Trust senior fellow, said: ‘Health systems all over the world are still dealing with the effects of the Covid-19 pandemic, with many still struggling to bring down waiting times. However, it's striking that in England our pace of recovery has been much slower for major surgeries like hip and knee replacements, but for some minor procedures we appear to have improved more quickly than nearly everywhere else.  

‘This should raise a host of important questions for the new government on what it will take to get ahead of the elective backlog and reinforces how for procedures that require the whole system to work well together we're really falling short.'

Rory Deighton, director of the NHS Confederation's Acute Network, said: ‘Our members recognise that reducing long waits and clearing care backlogs was never going to be achieved overnight while industrial action and some very difficult winters have also thrown a spanner in the works. Nearly 1.5m appointments and operations have been rescheduled due to strikes since 2022, with industrial action estimated to have cost the NHS billions in plugging staffing gaps and rescheduling appointments.'

Deighton said hospitals were trialling new innovative ways to manage elective procedures, including opening surgical hubs and hot and cold surgical sites but needed capital investment to repair crumbling estates and expand theatre space to boost productivity.