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Two NHS waiting time targets axed

Published 04/06/2015

Health Secretary Jeremy Hunt was speaking to the NHS Confederation
Health Secretary Jeremy Hunt was speaking to the NHS Confederation

Two waiting time targets are being scrapped by the NHS while changes are being made to the way A&E and cancer treatment waiting times are reported.

The move came following recommendations by NHS England national medical director Sir Bruce Keogh, who said that a "confusing set of standards" was leading to "perverse incentives" regarding the 18-week target from GP referral to treatment.

Health Secretary Jeremy Hunt outlined the changes at the NHS Confederation's annual conference in Liverpool, where he agreed that a "much more consistent approach" was needed to make sense of the figures and ensure they are helping patients.

Sir Bruce suggested two out of three of the 18-week referral to treatment time (RTT) targets be abolished, while a pilot testing the effectiveness of an eight-minute deadline for ambulances to respond to emergency calls be extended.

His recommendations have been accepted by the NHS while other changes will mean that A&E, cancer and RTT targets, which were published at different times either weekly, monthly or quarterly, will now be released together on one day each month.

NHS England said the two indicators being scrapped penalised hospitals for treating patients who had waited longer than 18 weeks while the one that will remain, for 92% of patients to be treated within the timeframe, is the only measure that captures the experience of every patient.

In his letter, Sir Bruce said getting rid of the two targets will "reduce tick-box bureaucracy and expose hidden waits".

But shadow health secretary Andy Burnham said the move demonstrated the "NHS is going backwards under David Cameron and waiting lists are at a seven-year high".

"Patients will wonder how scrapping these standards will help improve that situation," he added.

"The Government should be trying to get things back on track and ensure patients have quicker access to treatment, rather than focusing on moving the goalposts."

Labour said one of the targets being scrapped - the admitted adjusted target (that 90% of admitted patients should start consultant-led treatment within 18 weeks of referral) - has been missed for nine out of the last 12 months.

Mr Hunt told delegates the NHS is facing a "very, very challenging period in its history" before setting out a series of implementations he wants to see.

Referring briefly to the "scandal" of childhood obesity, he said the Government will be publishing a national childhood obesity strategy by the end of the year.

He said: "Bruce Keogh today has written a very important letter that points out the inconsistencies in the way we publish performance data with A&E figures published weekly, RTT monthly and cancer quarterly.

"And he has said that we need to have a much more consistent approach, published all monthly on the same day, and also include the safety statistics in that.

"And that way I think we can have much more consistency in the way we report performance."

The different targets were brought in under the Labour government a decade ago and have proved to bring down waiting times overall.

While 95% of patients who go to A&E are meant to be admitted, transferred or discharged within four hours, the target had been missed for 33 consecutive weeks until the most recent figures came out on Monday, when it was hit for the first time since September.

Today's changes were broadly welcomed by health leaders.

NHS Confederation chief executive Rob Webster said: "Simplifying hospital waiting time measures so that providers are no longer penalised for doing the right thing for patients is a welcome step.

"Our members have told us that we need targets which are evidence-based, reflect what matters to patients, and don't create unnecessary paperwork or perverse incentives."

Nuffield Trust chief executive Nigel Edwards said: "It is very welcome that the 18-week target for planned treatment is to be simplified, reducing the number of targets from three to one.

"Focusing on those still waiting for treatment, rather than the numbers of patients treated within a given timeframe, makes perfect sense. This should provide a more patient-focused measure of care."

Mr Hunt said he had "absolutely no problem" with NHS bosses earning more than the Prime Minister.

"Some of these salaries don't feel fair to the staff who work on the front line," he acknowledged.

"Let me be absolutely clear, I have no problem at all with people who do an outstanding job running hospitals getting very generous rewards, and getting paid more than the PM, I have absolutely no problem with that.

"If it's someone who has turned around a CQC chief inspector-rated hospital that's in special measures and turned it into a good or outstanding hospital, and somewhere where that salary can be justified on the basis of their track record or what they have delivered, then I will support it."

He added: "We need to be able to make that argument to staff who are working on the frontline who are on much, much lower pay.

"We won't carry them with us with all the very difficult changes we are going to have to make over the coming years unless we can make that justification."

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