The must-read stories and debate in health policy and leadership.

NHS England took a decisive step towards the first major change in how the service’s elective waiting list is collected and reported for 17 years — but major changes to the figures are not forecast.

NHSE wants to ditch the existing monthly “referral to treatment” collection from providers used to determine the length of the waiting elective wait list, a move that was proposed in a consultation that closed last month

NHSE is proposing to replace it with one based on the “waiting list minimum dataset”, a weekly collection, which has been around since 2021 but only used for “management” purposes rather than as an official statistic. 

HSJ understands the overall length of the list is unlikely to be altered by the change. Neither will the criteria for how patient waits are measured. This is because the underlying source data is the same for both the RTT and the WLMDS. 

It is also understood the core definition of what constitutes an “RTT wait” in terms of the criteria for the statutory waiting time standard will not change because of the switch to the WLMDS.

The differences are in how the data is collected and what can be done with it. You can read more about this in our story here.

But whatever happens longer term, nothing is likely to change for at least a year or so.

Rescue bid fails

NHS England’s controversial last-minute attempts to meet accident and emergency targets fell short in March, marking a setback despite fervent efforts. Four-hour A&E performance stood at 74.2 per cent, below the NHSE threshold of 76 per cent but showing improvement from 71.5 per cent last March.

NHSE’s initiatives to bolster A&E performance ahead of a year-end deadline included cash incentives, director commitments, and prioritising less critical cases, resulting in a 3.3 percentage point increase from February’s 70.9 per cent.

In March, 38 out of 119 acute trusts hit the 76 per cent target, a notable increase from just 15 in February. Several trusts witnessed substantial performance boosts, with Airedale Foundation Trust, James Paget University Hospitals FT, and Royal Devon University Healthcare FT all recording over an 11 per cent increase from February to March.

Despite slight improvements in A&E wait times, 72.1 per cent of patients waited under four hours for admission, transfer, or discharge in 2023-24, a dip from 76.7 per cent in 2021-22. Long A&E waits persist, with 147,650 attendances enduring 12-hour waits in March alone.

Also on today

In Mental Health Matters, Annabelle Collins looks ahead to the sector’s next five-year implementation plan, and HSJ editor Alastair McLellan explains our new stance on managing readers’ comments.