It was always a tough ask - could the NHS fundamentally change its ways of working for elective patients, transform the quality of the service that patients experience, reduce the backlogs of long waits, and cut waiting times dramatically?
"Waiting lists" and all they implied had seemingly been the norm forever. When 18 Weeks was first mooted in the 2004 NHS Improvement Plan, the commitment - that by December 2008, no one would have to wait longer than 18 weeks from GP referral until the beginning of treatment unless they choose to do so or it is clinically appropriate - seemed a long way away. At that time, many local health communities had just reduced maximum inpatient and day case waits to nine months, and first outpatient waits to 17 weeks. Organisations were taking a deep breath and setting their sights on getting down these down to six months and 13 weeks by the end of 2005. Diagnostic waits were largely unmeasured.
We can now pause to reflect back on the journey. Moving from stages of treatment to referral to treatment demanded a huge culture shift, and change in mindset, systems and approach. There has been a revolution in diagnostic services, with maximum waits systematically below six weeks, and routine waits as short as two or three weeks in many cases. This has been an engine to drive out unnecessary delays and has enabled referral to treatment waits to tumble.
However, more has been achieved that just bringing down waits. Services have been redesigned, with new pathways, more convenient settings, more efficient processes both for patients and for staff. Patients have been empowered, able to take more responsibility for their own care through having greater choice and being given better information about their care and treatment.
These things have been achieved by the extraordinary skill, determination and sheer hard work of huge numbers of people, involving almost every part of the NHS. In the following pages, you'll read about more of the success stories from around the country and across the service. Everyone should feel extraordinarily proud of their achievements in helping to deliver 18 Weeks.
Nick Chapman is the national director of 18 Weeks. Philippa Robinson is the national implementation director of 18 Weeks.