The operating framework 2007-08 identifies some concerns about NHS targets - in particular, missed mental health targets and risks around the 18-week referral-to-treatment target.
It calls for 'recovery action' to improve mental health services, as progress has slipped in some areas. The target for 500 community development workers to be in post by this month has been missed, and a revised deadline of next December scheduled.
It also calls for more action to cope with the 7,500 new cases needing early intervention annually.
The framework warns that the success of the 18-week target from referral to treatment could be put at risk if audiology patients who could be dealt with in primary care are unnecessarily referred to consultants, and thereby brought into the scope of the target.
PCTs are urged instead to commission enough 'direct access' activity to substantially reduce waits for audiology and, in particular, hearing-aid fittings.