It will be very challenging for the NHS to focus sufficiently on the needs of patients when it comes to dealing with backlogs, both patients already on waiting lists and those who have avoided seeking or been unable to obtain healthcare in the pandemic. NHSE&I is concerned about those people who have avoided or been unable to obtain healthcare during the pandemic. This includes the estimated 240,000 to 740,000 missing urgent cancer referrals since February 2020. There is also the huge challenge of communicating effectively with the 6 million people already waiting for elective care and providing them with support that they may require. NHSE&I expects trusts to focus on treating patients who have been waiting the longest. Recommendation: The Department and NHSE&I must ensure there is a strong focus on patient needs in all their recovery planning, including: • measuring the success of all initiatives to encourage patients to return to the NHS for diagnosis and treatment; • creating guidance and tools, and setting aside resources, for meaningful communication with patients who are waiting; and, • supporting NHS trusts through planning guidance and other means to prioritise patients fairly, so they are able to strike an appropriate balance between clinical urgency and absolute waiting time.