• NHS England says waiting time standards “will not be fully funded and met” next year “without offsetting reductions in other areas of care”
  • National body says £1.6bn announced by chancellor is less than what it asked for
  • Planning paper warns “the NHS will likely not be able to do everything being expected of it”

NHS England has warned that elective waiting time standards “will not be fully funded and met” next year unless there are cuts to services such as mental health, cancer and primary care.

In a planning paper published in response to last week’s budget, the national commissioning body said the additional £1.6bn announced by the government for 2018-19 is less than was requested by NHS England at the time of the Five Year Forward View settlement in 2015.


Philip Hammond said the government had ‘met the funding ask’ of the Five Year Forward View

This appears to contradict chancellor Philip Hammond who said the government had “met [the] funding ask” of the forward view.

The NHS England paper said despite successful efforts to increase productivity above the levels achieved in the wider economy “the NHS will likely not be able to do everything being expected of it” with the budget available next year.

It said this will “therefore require realism and some difficult judgements about priorities”, but argued it would be “unacceptable” if mental health, cancer and primary care services were used as a “balancing item” relative to other services.

The paper continued: “Our nurses, doctors and other frontline staff routinely ‘go the extra mile’ for their patients. It would however be unfair to set unattainable goals, which staff would then be criticised for not meeting.

“In part, this therefore means more scrutiny of unfunded new expectations that are loaded on to the NHS.”

The document refers to new advisory guidelines from the National Institute for Health and Care Excellence and the expectation set out in the budget document to improve performance against elective waiting times.

On elective treatment, NHS England said: “However, even with some increased volume, and even assuming this year’s unprecedented elective demand management success continues, our current forecast is that – without offsetting reductions in other areas of care – NHS constitution waiting times standards, in the round, will not be fully funded and met next year.”

The paper suggested much of the £1.6bn will be needed to offset existing deficits in the provider sector, as contingency funding within the NHS will be needed to cover current spending levels by clinical commissioning groups.

It added: “With no obvious respite in the pressures on social care, and with transformation funding for NHS vanguards [ceasing] from April 2018, it will be important to set realistic plans for the growing level of emergency activity that hospitals and ambulance services will need to respond to next year.”

A Department of Health spokeswoman said the new money in the budget was to help the NHS ”make progress on A&E and waiting time performance”, adding: “NHS England will use that money to make sure every patient gets the treatment they require in a timely way.”

Meanwhile, following a consultation launched earlier this year, NHS England confirmed that several drugs and treatments of “low clinical effectiveness” will no longer be funded, and restricted the use of 11 others.

Those which will no longer be prescribed include Co-proxamol, Rubefacients, Lutein and Antioxidants, homeopathy, and herbal treatments. NHSE says this is expected to save £141m per year.

It said it will also launch a consultation on curbs to prescriptions for some ‘over the counter’ products such as paracetamol and ibuprofen, which could save around £190m per year.


NHS England: Waiting targets will be missed without cuts to other services