Access to NHS services has reduced significantly during the COVID crisis, potentially creating huge pent-up demand, which will add to the substantial waiting lists that existed before the pandemic.77 NHSE&I told us that access to emergency and critical services, such as cancer, has been maintained throughout the crisis although use of these services had been lower than usual. It also told us that it was now encouraging the NHS to resume more routine services.78 Stakeholders from the NHS and independent provider sectors have expressed concerns that resuming services, while the pandemic is still ongoing and with the potential for a second peak, will be challenging and will require full use of capacity across both sectors.79 We asked NHSE&I what plans it had to address these concerns in the near future. NHSE&I told us that the arrangements with the private sector were likely to continue for the rest of the year in order to provide a continuing ‘buffer’ for routine surgery, cancer care and other conditions but it noted that the basis on which it contracted with independent hospitals was likely to change and it was likely to follow a competitive procurement. As discussions are still ongoing, NHSE&I could not provide details on how independent hospital capacity would be allocated but assured us that it would be available for networks of hospitals and GPs in a given area to draw on. It also said that the Nightingale hospitals would be on standby in case of a second pandemic peak.80 72 Q 56; C&AG’s Report, para 10; RSC0007 Independent Healthcare Providers Network submission; RSC0010 NHS Confederation submission 73 Q 63; RSC0004 NHS Providers submission; RSC0007 Independent Healthcare Providers Network submission; RSC0006 Spire Healthcare submission 74 Qq 64–74 75 C&AG’s Report, para 2.7; RSC0011 Future Care Capital submission 76 Q 65 77 Q 59; C&AG’s Report, para 12; Committee of Public Accounts, NHS waiting times for elective and cancer treatment, One Hundredth Report of Se