Trusts could lose their share of the £250m elective fund if they do not perform increased numbers of patient procedures, the chief executive of NHS England has warned.

In his report to the organisation’s September board meeting, Simon Stevens said that if NHS hospitals did not soon use their share of extra funding made available to clear waiting list backlogs, commissioners should spend it elsewhere.

The £250m was released by the Department of Health in June, to fund additional operations and treatments to bring down long waiting lists.

Mr Steven’s board report, published this week, said: “On elective waiting times, extra funding was made available earlier this summer for more elective activity to meet [referral to treatment] waiting times standards.

“If this cannot soon translate to the agreed increases in operations at local NHS providers, [clinical commissioning groups] will need to use unspent funds buying operations from elsewhere.”

Trusts were expected to spend the summer months clearing their backlogs of patients waiting over 18 weeks.

However, the latest data on elective performance covering July showed there had been no increase in the number of elective procedures despite the extra funds being made available.

Several chief executives have argued that it has been difficult to perform increased numbers of elective procedures because of clinicians and patients going on holiday over the summer months.

Private providers could be asked to take on elective work, and trusts with large backlogs may have already outsourced some of this work.

Mr Stevens identified accident and emergency and elective performance as priorities for the next six months.

He said: “The NHS needs to improve its performance on fundamental access and care standards through the autumn and winter. The public attaches great importance to these measures, and success over the next 3-6 months will require strong partnership working between providers, CCGs and others locally, as well as joined-up leadership from [the NHS Trust Development Authority], Monitor and NHS England, regionally and nationally.”

He also warned that a separate £400m “winter pressures” fund - announced in June to help the NHS cope with additional demand over the winter months - might have to be accessed early to finance “extra capacity”.

Mr Stevens said that providers may need to “open ahead of time some of the extra capacity they were planning for using the ‘winter’ £400m”.

However, he added that while demand was rising and there were “substantial pressures”, many of the emergency admissions appeared “to be for quite short lengths of stay”.

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