Published: 05/09/2002, Volume II2, No. 5812 Page 4

The NHS is keeping pace with the demanding activity targets set for the current financial year - but only just.

NHS chief executive Nigel Crisp told HSJ that unverified figures for the first four months of the year show that inpatient activity is up 4.8 per cent on the same period in 2001. The target for the full financial year is 5 per cent. This performance contrasts with the first months of the 2001-02 financial year, which saw no increase in activity over the previous year.

This suggests that the service has responded to the NHS chief executive's exhortation to 'take risks' to ensure that activity increases smoothly throughout the year. Mr Crisp had warned that this year's targets were simply too steep to be meet in the traditional NHS lastquarter rush (news, pages 4-5, 11 April).

Mr Crisp said that he was further encouraged by figures showing that the increase in GP referrals was running at just 1 per cent, giving a differential between the rise in inpatient activity of 3.8 per cent. The target differential for the whole year is 3 per cent.

Mr Crisp acknowledged that outpatient services were a greater cause for concern, but said he was confident the situation would improve as the NHS began to focus on it. Although in April he had specifically encouraged managers to use spare capacity in the private sector, Mr Crisp said that the increase in activity was linked to a wide range of factors - including efficiency improvements and extra resources.

NHS Confederation chief executive Gill Morgan said that the activity figures reflected 'how it is out there'. But despite the increase in activity, she said managers still remained concerned that the targets and the funding associated with them did not take into account the 'inherent stretch' in resources with which the service was continuing to struggle.

Julie Moore, director of operations at University Hospital Birmingham, said her trust's increase in inpatient activity was broadly in line with the national picture.

She explained that the improvement in performance was largely down to factors such as 'getting better at things like pre-admission' and carrying out more day surgery. She concurred that outpatient waits were the bigger issue, largely due to the greater volume and uncertain demand.

However, Professor John Yates from the health services management centre at Birmingham University, who has analysed the activity figures for the first three months of 2001-02, takes a more pessimistic view.

In an article to be published in 19 September edition of HSJ, he claims the government 'will soon realise they are being duped by the NHS, which seems to be admitting long-wait patients at the expense of shorter waits'.