• Health and social care secretary says case for changing core waiting times targets would have to be “watertight”
  • Comes as NHS long-term plan reviews clinical standards

The case for changing the core NHS performance standards would need to be “watertight”, Matt Hancock told HSJ.

The health and social care secretary said he was looking forward to the results of the current review of targets – part of the NHS long-term plan – but indicated he would not automatically accept a recommendation to scrap headline objectives like the four hour wait in emergency departments, or the 18 week wait for elective treatment.

Mr Hancock said: “It’s perfectly reasonable to look at the clinical evidence of the impact of the targets, and to ask whether they are as clinically appropriate as they can be. And then to make an argument for how they might change.”

He said changes to ambulance service targets in 2017 – which were developed and phased in over a longer period – were “a case in point” of how it was possible.

But he said targets were based on what the public wanted, and the spending of taxpayers money was “of course a political decision”.

Pressed on whether, if a clinical review proposed change, he would accept it, he said: “It is a matter of whether the case is strong enough. So it’s not just about whether it’s recommended or not to change, it’s also whether the case to change is, in my view, watertight.”

Changes to the ambulance waiting times in July 2017 were met with outrage by some national newspapers.

In July senior NHS leaders said, while they welcomed a debate on changes to emergency targets, scrapping the four hour standard completely was “too dangerous”.

Northumbria Healthcare Foundation Trust chief executive Jim Mackey, who ordered a review of targets when he was NHS Improvement chief executive, told HSJ: “We must not forget how bad things were before the standard. I wouldn’t ditch [the four hour target] completely – that would be too dangerous.” But he said there would be value in “taking the opportunity to make it more clinically relevant for today [and] adaptable for the future”.

Salford Royal Foundation Trust boss Sir David Dalton said: “Review, reassessment and where appropriate, recalibration of ‘what’ we measure and ‘how’ we measure is sensible… I welcome the signal that we should now talk more openly about the standards that matter most to us – and ensure that these are always aligned to what we want to attach importance to.”

The service has not hit the target for seeing 95 per cent of patients within four hours at consultant led emergency departments since September 2012. The more forgiving measurement against this, which also includes urgent care centre attendances, has not been hit since September 2014.

In June 2015, the NHS changed the target for elective treatment times, with a new rule that 92 per cent of patients on the waiting list should have waited no longer than 18 weeks. The target, which is a legal requirement under the NHS Constitution, has not been met since February 2016. In August there were 4.15m people on the waiting list, the highest total since August 2007.