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NHS organisations ‘not sufficiently held to account’ over elective waiting time standards

NHS organisations ‘not sufficiently held to account’ over elective waiting time standards
By Valeria Fiore Reporter
12 June 2019

NHS local bodies are ‘not being sufficiently held to account’ when it comes to ensuring patients are treated within the minimum waiting time targets, a new report has said.

The NHS waiting times for elective and cancer treatment report, released by the Public Account Committee (PAC) today, said that patients are being let down by the NHS’ failure to meet the 18-week elective care waiting time standard and the 62-day standard from a GP referral for suspected cancer to treatment – which have been unmet since 2016 and 2013 respectively.

According to the report, the number of patients on the waiting list for elective care grew from 2.7 million in March 2013 to 4.2 million in November 2018.

It lambasted national bodies responsible for implementing these standards, which it said ‘appear to lack curiosity’ about the risks incurred by patients when waiting for treatment.

However, an NHS England spokesperson said that the report failed to consider that ‘hard-pressed NHS surgeons, nurses and other staff are treating hundreds of thousands more patients within the current waiting times targets than they did even three years ago, and cancer survival is now at a record high’.

A Department of Health and Social Care (DHSC) spokesperson said: ‘Over a million NHS patients start planned treatment with a consultant every month – with the majority seen and treated within 18 weeks – and last year, 71,000 more people began their cancer treatment than in 2010.’

Missed waiting time targets

The report said that less than half of NHS trusts and foundation trusts met the 18-week waiting times standard for elective treatment, while only 38% meet the waiting time standard for cancer patients.

It recommended that NHS England and the DHSC deliver additional support to help local NHS bodies meet the waiting time standards, and that the DHSC should hold NHS England to account ‘for achieving waiting times standards now and in the future’.

The PAC report said that, since 2015, NHS England has ‘gradually removed financial sanction and penalties against trusts failing to meet elective waiting time standards’.

NHS England told the PAC MPs that this measure was taken to alleviate the financial burden on trusts, many of which are already in financial difficulties.

Instead, NHS England reintroduced sanctions for both commissioners and providers when patients wait 52 weeks or over for treatment in January.

Review of NHS access standards

In an interim review of NHS access standards, published in March, the NHS proposed the introduction of a ‘28-day standard from a patient’s referral to their diagnosis’, which would replace the two-week waiting time standard from a patient’s referral to their first appointment with a consultant.

However, stakeholders including the Independent Healthcare Providers Network and arthritis charity Versus Arthritis told the PAC that they feared ‘the review could be used as an opportunity to make the target easier to meet or less appropriate’.

Commenting on the report, PAC chair Meg Hillier said: ‘NHS England’s review of waiting times is now more crucial than ever. However, this cannot be an opportunity for standards to slip. Any changes must protect and improve patient outcomes.’

NHS Providers director of policy and strategy Miriam Deakin said that although trusts are working ‘flat out to meet the constitutional standards’, staff shortages, financial pressures and increasing demand have made it difficult for them to meet them.

She added: ‘Trusts are rightly prioritising patients who are most sick, but that has a knock-on impact on other parts of the service. We now have a growing waiting list, which risks pushing even more people towards emergency care if their condition deteriorates.’

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