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The NHS in England heads into its busiest winter on record “at a loss” about the Government’s priorities for the service, health leaders have warned, urging ministers to be honest about the trade-offs required to meet performance targets.
Prime Minister Sir Keir Starmer was last week named as one of “Features” of his new policy The aim is to ensure that 92% of NHS patients in England wait no longer than 18 weeks after referral to begin non-urgent hospital treatment.
Health Minister Wes Streeting also pledged to go “hell for skins” in meeting all “broken” service performance targets in the next five years with wide-ranging reforms to how care is delivered.
However, many of the targets have not been met for nearly a decade, and with waiting lists at near-record levels, Stretching told health chiefs at an emergency meeting on Monday to prioritize the sickest patients over accident and emergency targets until March.
“There is tremendous confusion right now,” one hospital executive said. “There's all this rhetoric about reform, as well as this shift to preventative health care, but at the same time we're being told that we have to achieve these goals.”
He promised the street Three “big transformations” In this Parliament about how the NHS delivers treatment by moving “from hospital to community”, “from disease to prevention” and “from analogue to digital”.
But the hospital director added: “The three wise men working the three shifts will turn up and find the stable empty because everything has been invested in achieving the 18-week target.”
The number of hospital beds occupied daily is on average 96,587 at present, according to the latest official Datawith long waiting times in A&E continuing to rise and backlogs in the social care sector increasing the number of late discharges.
NHS leaders have done too to caution On the pressure caused by the “quadruple pandemic” of Covid-19, influenza, norovirus and respiratory syncytial virus, with figures showing hospital influenza cases rising by 350 per cent at the end of November compared to the previous year.
Siva Anandaseva, senior policy analyst at the King's Fund thinktank, said health chiefs were wondering: “What exactly is agreement on all the targets beyond the 18-week period? It sounds confusing, and one of the last things you want in the health system as we head into winter is confusion about… Priorities.
In the near term, he added, “hospital CFOs will be sitting there thinking: 'I know I should be investing more in meeting the 18-week benchmarks, but what was I supposed to do with my A&E?'
The 18-week target, introduced by Tony Blair's Labor government in 2004, has not been met since February 2016, when the Conservatives were in power. About 60 percent of patients have been seen within the time frame in recent years.
In the same period, the health service consistently failed to meet its pledge to admit, transfer or discharge 95 per cent of patients within four hours of their arrival at A&E. Only 73% of people in this time frame were seen in October, the most recent month for which data is available.
in A government-commissioned review into the NHS This year, surgeon and former Labor health minister Lord Ara Darzi warned that the struggling service was “unlikely” to clear waiting lists and restore other standards during the current Parliament.
Latest OECD data shows that the UK invests less in health services than many other advanced economies, and has the lowest number of hospital beds per capita among all G7 members.
Anandaseva said the health sector saw Stretching's “big transformations” as a “north star” but “prioritizing the 18-week target feels like a handbrake on that reform agenda.”
He added: “I am awaiting clarification on how to transform the care model while at the same time achieving these goals in just one parliament.”
Ministers said they would publish their ten-year plan for the NHS in the spring, and have so far set out plans to provide an additional 40,000 routine hospital appointments per week to help reach the 18-week target.
Mark Dayan, policy analyst at the Nuffield Trust think tank, said Starmer's choice of the 18-week target “clearly has implications for what the NHS can do”.
“With a time frame of 4-5 years… the government will need to confront trade-offs,” he added.
The Department of Health and Social Care said: “Our plan for change sets out the key milestones by which people can judge us by the end of this Parliament – and this includes reducing NHS waiting times to the 18-week standard they have come to expect.
A government spokesman said: “The £26 billion provided to the NHS in the budget means we can drive improvements across the rest of the NHS at the same time.”
