The NHS is not planning to meet the 95 per cent national accident and emergency waiting target for 2018-19, under new system rules published today.
It is also not expected to meet the planned care waiting time target, nor to substantially reduce the current long waiting list for operations.
This is despite ministers indicating the health service should be able to start to meet its targets when extra funding was allocated to the NHS in November’s budget. The budget document said: “This funding should enable the NHS to meet the A&E four-hour target next year, make inroads into waiting lists and improve performance against waiting time targets.”
At the time, NHS England said it wasn’t enough funding to meet the requirements on the NHS, and that tough decisions would have to be made about priorities.
Planning guidance for 2018-19, published today by NHS England and NHS Improvement, does not expect the four-hour accident and emergency target to be met.
It extends by a year the NHS’s previous targets, requiring 90 per cent performance overall in September 2018, and that the “majority” of providers should achieve the 95 per cent target by March 2019.
It says the NHS as a whole was only expected to achieve the standard “within the course of 2019”.
To access the performance part of the Provider Sustainability Fund, which accounts for 30 per cent of what trusts achieve, they will need to achieve either 90 per cent against the A&E target or do better than they did in the equivalent quarter of 2017-18.
At the time of the autumn budget, the government expected the majority of the £1.6bn additional funding it granted to health to be spent on reducing the elective waiting list.
However, today’s guidance says only that additional funding will allow the waiting list to be held at the same level in March 2019 as it will be in March 2018. In some local areas it may be reduced. In March 2017 the total number reached 4 million, up by nearly a million over the previous two years.
The national planning guidance also says providers would need to halve the current number of patients waiting more than 52 weeks for treatment. There is no mention of the 18-week referral to treatment target, which features in the NHS constitution.
These figures are based on assumptions of 4.9 per cent growth in outpatients, and 3.6 per cent in elective admissions. There is a move to hold down GP referrals, keeping growth at 0.8 per cent year-on-year, whereas the most recent figures for GP referral growth was 1.6 per cent.
There will also be a “quality premium” worth £210m for clinical commissioning groups to control emergency care demand.
On delayed transfers of care, the guidance asks for a return to 3.5 per cent of bed base over the course of the year - with an even division between breaches allocated to the NHS and those allocated to social care. A 3.5 per cent performance has not been achieved since quarter one of 2014-15.
A focus on “stranded” and “super-stranded” patients, those waiting for more than seven and 21 days in hospital respectively, is also expected from providers.
2018-19 planning guidance
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