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NHS failing to cut waiting lists, finds NAO

A report by the National Audit Office (NAO), ‘NHS waiting times for elective and cancer treatment’, has raised concerns over the lack of capacity in the NHS and resulting increase in waiting times for patients.

While the report acknowledges that the NHS has increased the number of people it treats each year, it found that the percentage of patients treated within waiting times standards continues to decline for elective (non-urgent care) and cancer treatment.

The elective care standard – 92% of patients seen within 18 weeks after referral – was introduced in 2012 and was last met nationally in February 2016. The waiting list has grown from 2.7 million to 4.2 million between March 2013 and November 2018 and the number waiting more than 18 weeks has grown from 153,000 to 528,000.

Similarly, the target for cancer care – 85% of patients treated within 62 days of an urgent GP referral – has not been met since the end of 2013. According to the report, in November last year only 38% of NHS trusts met this standard.

Amyas Morse, head of the NAO, commended the NHS’s actions to increase the number of urgent cancer referrals, helping more patients to be diagnosed at earlier stages, but said this has resulted in waiting times standards for cancer care no longer being met.

Morse added: “With rising demand for care as well as constraints in capacity, it’s hard to see how the NHS will be able to turn around this position without significant investment in additional staffing and infrastructure.”

The NAO estimates that an additional one-off cost of £700 million is required by the NHS to reduce the elective care waiting list to the size last seen in March 2018, and is calling on NHS England and NHS Improvement to set out how declining performance will be addressed.

David Hare, chief executive of the Independent Healthcare Providers Network (IHPN), said that additional support will be needed to improve waiting times. He said: “It’s vital that the significant spare capacity in the independent sector is utilised by local areas to ensure patients can we treated as quickly as possible, including through exercising their right to choose the best care provider for them.”

Last week NHS England proposed to end the 18-week waiting standard for elective care, replacing it with an average waiting target; if introduced, patients will be offered the choice of an alternative provider, which could be independent. This supports plans laid out in the NHS Long Term Plan, which committed to an increase in planned surgery delivered, thus cutting waiting lists.

David Furness (pictured), director of policy at IHPN, told HealthInvestor UK: “In the last few years the NHS has been carrying out less elective activity which has had a knock-on effect on referrals to the independent sector. As a result waiting times are at record levels and the NHS has not met the legal standard to treat 92% of patients within 18 weeks for three years.

“We therefore welcomed the recent NHS Long Term Plan which committed to increase the amount of planned surgery delivered year-on-year, including through making use of independent sector capacity. What we now need to see from NHS England is a clear delivery plan on how to get waiting times down, including a national programme to identify spare capacity in the system and fulfil the new promise to offer those waiting over 26 weeks a choice of faster treatment elsewhere”

Posted on: 22/03/2019

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