The bosses of clinical commissioning groups and NHS providers have been told to raise their game to hit waiting time targets in a letter from NHS England, Monitor and the NHS Trust Development Authority.

It also reveals that national officials are now not expecting the flagship elective waiting time targets to be met until after the end of November. Earlier in the summer they had hoped they would be met in September.

Simon Stevens, David Bennett and David Flory, the chief executives of NHS England, Monitor and the NHS Trust Development Authority respectively, said “very high demand” in 2014-15 had made delivery “ever more challenging”.

However they said: “It is essential that you continue to focus on meeting the NHS constitution standards and take rapid action to improve performance where these standards are not being met.”

The letter (see attached) was sent to NHS provider chief executives and CCG leaders today.

It referred to accident and emergency, diagnostics, cancer waits and ambulance response times as well as elective waiting times. The letter said these would be “recovered so that they are all met consistently”, although no timescale is given for this.

In relation to the 18 week referral to treatment targets for elective care the letter says additional procedures to cut waiting lists must be carried out “by the end of November”, meaning the target would be met “consistently thereafter”. HSJ reported earlier this month that the NHS had not significantly cut waiting lists during the summer, despite the Department of Health allocating an additional £250m for the purpose.

The letter said the additional funding for elective care, and money allocated to aid winter performance “will play a significant role in helping you to deliver these standards and we will be working closely with you to ensure that these resources are deployed to best effect”.

In the letter the three chief executives also state they had set up “a strengthened partnership across our organisations so that we can take a joined-up view of the challenges facing the NHS, and the potential solutions available”.

It said this “will include developing a common approach to escalation across our organisations” – suggesting a change to how poorly performing organisations are dealt with.

The letter also discusses the planning process for 2015-16, in which funding for NHS services is expected to be significantly tighter than this year. It says there will be a “focus on making sure that the plans are as realistic as possible” and that organisations should “work together to develop aligned plans and collective risk management arrangements”.

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