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I don't think PCT managers seriously want people to die through the delays or even go private. They are using this as a short-term cash saving measure to hit annual targets. What it means though is that the next year you have to deal with the backlog as waiting time performance will go South and over capacity will need to be created at premium rates with huge management resource, largely in providers,trying to manage the patients on the list.

If only management effort could go into delivering QIPP and not reconfiguring or dealing with this kind of problem we might actually get somewhere!