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England’s NHS is entering its busiest winter ever and is “confused” about the government’s priorities for the service, health leaders have warned, urging ministers Be honest about the trade-offs necessary to achieve performance goals.
Prime Minister Sir Keir Starmer was last week named one of the his new policy “milestones.” target to ensure 92% of NHS patients in England wait no more than 18 weeks after referral to start non-urgent hospital treatment.
Health Secretary Wes Streeting has also vowed to make every effort to meet all “broken” service performance targets over the next five years, while also implementing wide-ranging reforms to how provide care.
However, many targets remain unmet for nearly a decade and with waiting lists at near record highs, Streeting told health chiefs in an emergency meeting on Monday to prioritize those unwell patients instead of accident and emergency targets until March.
“There is great confusion right now,” said one hospital executive. “There is all this rhetoric about reform, as well as a shift to preventative health care, but at the same time we are being told that we have to achieve these goals.”
The streets promised three “big changes” this parliament on how the NHS delivers treatment by moving “from hospital to community”, “disease to prevention” and “analog to digital”.
But the hospital boss added: “Three wise men working three shifts will arrive and find the stables empty because everything has been invested to complete the 18-week target.”
According to the latest official data, there are currently a record daily average of 96,587 hospital beds in use. dataas long waiting times in A&E continue to rise and backlogs in the social care sector will increase the number of delayed hospital discharges.
NHS leaders also have it warning on pressure from the “pandemic quartet” of Covid-19, influenza, norovirus and respiratory syncytial virus, with figures showing the number of flu cases in hospitals rose 350% at the end of November compared with a year before.
Siva Anandaciva, principal policy analyst at the King’s Fund think tank, said health leaders are asking “what exactly is the agreement on all the targets beyond the 18-week target? It feels confusing, and one of the last things you want in a health system going into winter is confusion about priorities.”
Going forward, he added, “the hospital’s chief financial officer [would be] sitting there thinking, ‘I know I should invest more to get to the 18-week benchmark, but what do I do with my A&E?’”
Introduced by Tony Blair’s Labor government in 2004, the 18-week target has not been met since February 2016, when the Conservatives took power. About 60% of patients have been seen during this time period in recent years.
During the same period, the health service also consistently failed to meet its commitment to admit, transfer or discharge 95% of patients within four hours of arriving at A&E. Only 73% of people were seen during this time frame in October, the most recent month for which data is available.
IN a government-commissioned review of the NHS This year, surgeon general and former Labor Health Secretary Lord Ara Darzi warned that the struggling service is “unlikely” to clear waiting lists and restore other standards in the current parliament in.
The latest OECD data shows that the UK invests less in health services than many other advanced economies and has the fewest hospital beds per capita of all G7 members.
Anandaciva said the health sector had seen Streeting’s “big changes” as the “North Star” but “prioritizing the 18-week target seems a bit like a handbrake on that reform agenda”.
He added: “I am waiting for an explanation of how you can transform the care model, while meeting these targets in just one parliament.”
Ministers said they will publish a 10-year plan for the NHS in the spring and have so far set out plans to deliver 40,000 extra routine hospital appointments a week to help meet 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 will be able to do”.
“With a time frame of 4-5 years. . . The government will need to face trade-offs,” he added.
The Department of Health and Social Care said: “Our change plan sets out key milestones by which people can judge us by the end of this parliament – this includes reducing waiting times NHS waiting times are down to the standard 18 weeks they expect.
A spokesman said: “The £26bn provided for the NHS in the Budget means we can drive improvements across the rest of the NHS at the same time.”
