This joint webinar from RCSEd and BOA will explore the issues arising from the almost complete cessation of elective orthopaedic activity for a year due to the COVID-19 pandemic. We will review the present waiting list situation, how it has developed and how it may change. The majority of patients on the waiting list will deteriorate over time, but some may opt to decline surgery and others will decline catastrophically with long term implications for the outcome. How do we assess them and prioritise care in an environment of limited resources? How do we ensure equality of access across a whole nation or across a city? How do we assess the unmet need where patients are even reluctant to seek help in the community or primary care? How do we make the very best use of the resources we have so that management is both effective, efficient and safe?