£700m needed to hit waiting time target

25 March 2019 Seamus Ward

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A report on waiting times for elective and cancer care said in November 2018, 87.3% of patients had been on waiting lists for fewer than 18 months – missing the standard of 92%. The standard was last met nationally in February 2016.amyas-morse1

In cancer, the key standard giving 85% of patients access to treatment within 62 days of an urgent GP referral has not been met since the end of 2013.

NHS Improvement and NHS England asked trusts to ensure waiting lists in March 2019 were no greater than 12 months earlier, but, based on current trends, the NAO estimates it would cost an additional £700m to achieve this.

The elective waiting standard is being met in some specialties, such as general medicine, but not others, such as the surgical specialties. In cancer care, performance for lung, lower gastrointestinal and urological cancers was significantly lower than in others.

Demand is growing – annual elective referrals grew by 17% between the 12 months to March 2014 and the 12 months to November 2018. Urgent referrals for suspected cancer increased by 94% between 2010/11 and 2017/18.

The NAO said constraints on finance, staff and beds were linked with the decline in waiting times performance. There have been persistent staff shortages in diagnostic services, while the gap between demand and staff numbers has also widened.

Bed occupancy has increased, the number of beds has reduced by 7% (8,000) since 2010/11. The auditors said that reducing beds increased efficiency, but after a certain point the capacity challenges this creates will impact on other resources, such as staff and theatre use.

Amyas Morse (pictured), the head of the NAO said the NHS had made some progress on cancer diagnosis.

‘The NHS’s actions to increase the number of urgent cancer referrals are a positive step. They have helped to diagnose more patients at earlier stages, leading to better outcomes, even though this has meant that waiting times commitments for cancer care are no longer being met.’ 

But he added: There has been insufficient progress on tackling or understanding the reasons behind the increasing number of patients now waiting longer for non-urgent care. With rising demand for care as well as constraints in capacity, it is hard to see how the NHS will be able to turn around this position without significant investment in additional staffing and infrastructure.’