Commissioners and providers who are found in breach of the 52-week waits for elective treatment will be subject to sanctions, according to the 2019/20 NHS Planning Guidance.
The guidance, published on 10 January, states that providers and commissioners could be both fined £2,500 per breach.
The guidance said: ‘Following good progress in 2018/19, we expect no patient to be waiting more than 52 weeks for treatment. Given that over the coming years there will be sufficient funding available to CCGs and providers to avoid long waits, financial sanctions must be applied for any patient who breaches 52 weeks.’
However, the final decision is subject to the outcome of the NHS Standard Contract consultation, the final version of which will be published in February.
The Draft NHS Standard Contract 2019/20: a consultation proposes that, given that ‘52-week breaches are typically a symptom of whole-system level problems’, commissioners should also receive a sanction mirroring that imposed on providers, possibly from April 2019.
The consultation document said: ‘The overall value of 52-week breach sanctions, in total, will remain at the 2018/19 level of £5,000 – but the burden will be shared between provider and commissioner, giving each an equal incentive to reduce long waits.’
In 2013/14, NHS England introduced an operational standard to make sure no-one waits more than 52 weeks for treatment.
However, the 52-week breach sanction for providers was suspended last year for providers who signed up to the Provider Sustainability Fund.
Over 2,000 patients waiting more than 52 weeks
NHS referral to treatment waiting time data, also published yesterday, showed that 4.2m patients were waiting to start treatment at the end of November 2018, and that 2,432 of those had been waiting more than 52 weeks.
The document said: ‘Extremely long waiting times for elective treatment lead to poorer quality of care, are frustrating for patients, and present patient safety risks.
‘Subject to the outcome of the Standard Contract consultation, we propose that new arrangements would apply for 2019/20 in respect of sanctions for 52-week breaches.’
NHSCC chief executive Julie Wood told Healthcare Leader: ‘We understand the need to ensure that patients aren’t waiting too long for elective care and it will be important to have ways to fund care if a patient is then treated somewhere else.
‘However, we would like to understand how this will work in practice in the context of an ICS, with population based budgets, in order to make sure that it will have the desired effect to improve performance, rather than penalising a system when long waits may be caused by a multitude of factors.’