Hunt reveals changes to NHS targets


Published: Thursday 4th June 2015 by The News Editor

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Health Secretary Jeremy Hunt has outlined changes to the way controversial performance targets such as A&E and cancer treatment waiting times are reported.

Mr Hunt, s peaking at the NHS Confederation’s annual conference in Liverpool, agreed that a “much more consistent approach” was needed to make sense of the figures and ensure they are helping patients.

He referred to a letter written by NHS England national medical director Sir Bruce Keogh that said a “confusing set of standards” was leading to “perverse incentives” regarding the 18-week target for patients from when they are referred by their GP to when they receive treatment.

He suggested two out of three parts of the 18-week referral to treatment times (RTTs) 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 12 weeks, while the one that will remain is the only measure that captures the experience of every patient waiting.

Responding to the announcement, shadow health secretary Andy Burnham said it 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 changes he wants to see.

“Most of these efficiencies are going to take a huge amount of effort from the people in this room,” 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.

Sir Bruce’s letter said the scrapping of the two targets will “reduce tick-box bureaucracy and expose hidden waits”.

The RTT target that remains is for 92% of patients to be treated within 18 weeks. NHS England said the number of patients waiting longer than this reduced by almost 100,000 in the first year after it was announced.

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.”

Published: Thursday 4th June 2015 by The News Editor

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