The penalty imposed on providers who breach the remaining elective waiting time target is to be increased, regulators have told all NHS providers and clinical commissioning groups.
- Sanction for “incomplete” referral to treatment target proposed to rise
- National leadership will also get tough on providers not reporting RTT data
- Two other RTT targets were dropped following review by Sir Bruce Keogh
Two of the referral to treatment waiting time standards – admitted and non-admitted – were abolished at the start of the month.
A letter to provider chief executives and CCG senior leaders from NHS England, Monitor and the NHS Trust Development Authority, sent last week, sets out the detail of the new approach to RTT performance.
The national bodies said they will consult on increasing the penalty for breaching the “incomplete” target, which stipulates that no more than eight per cent of patients should be waiting longer than 18 weeks to start treatment.
The letter, seen by HSJ, said the proposed increase is “in line with our commitment to the incomplete standard as the single new measure of RTT performance”.
It is not yet clear what the new penalty will be but it is expected to come into effect from October. The letter said this means providers “have three months to improve their incomplete performance before contract sanctions increase”.
There will be a “much more stringent approach” to trusts who do not report their RTT data “particularly for providers about to undergo patient administration system upgrades”, the letter said.
Over the past two years an increasing number of trusts have stopped reporting their waiting times data and many have blamed the introduction of new patient administration systems.
The letter added: “This is to ensure that ceasing reporting only happens in the most exceptional circumstances and that there is a clear and transparent process to recommence reporting as quickly as possible.”
The new RTT regime has been retrospectively applied from 1 April and any CCGs that fined providers for breaching the admitted or non-admitted targets have been told to repay the money.
NHS England will also add more information to its RTT monthly reporting statistics. These will now include the number of clock starts, decisions to admit and the number of patients who were removed from the waiting list as a result of checking data and finding inaccuracies.
The “admitted adjusted” data will be removed with the aim “to understand better the waiting list dynamic”. The data has been criticised in the past for being overly complicated.
The letter said: “We understand that both commissioners and providers are currently under significant pressures. It is our intention that the simplification of RTT standards and reporting requirements will support you in focusing on what really matters in what we all recognise will be a challenging year.”
From August, RTT, accident and emergency, cancer, diagnostics, ambulance, NHS 111 and delayed transfers of care will all be published monthly on the same day.
Weekly collection of A&E data will stop from the beginning of next month.
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