NHS England and NHS Improvement have effectively dropped routine financial penalties for trusts that fail to meet elective and cancer waiting times targets, HSJ has been told.

Earlier this month, HSJ revealed that the chief executives of the two bodies had written to trust leaders saying that from April 2017 sustainability and transformation fund money would only be made available to trusts hitting their accident and emergency targets. During 2016-17, 12.5 per cent of the money was released when trusts hit A&E targets, 5 per cent for cancer targets and 12.5 per cent for elective waiting time targets.

Because the STF bailout scheme acts as a financial incentive to trusts, it replaced the standard contractual penalties for the non-delivery of these targets.

Well placed sources told HSJ that contractual penalties were not expected to be reintroduced for elective and cancer targets in 2017-18, despite the incentive being removed from the STF.

NHS England and NHS Improvement also in December effectively dropped penalties for 12 hour trolley waits in A&E, year-plus waits on an elective pathway and some cancer standards. Trusts at that point were required only to submit an “assurance statement to NHS Improvement, confirming their commitment to deliver the national standard in full on an ongoing basis”, to be let off. Clinical commissioning groups will not be allowed to levy local penalties unless agreed with trusts.

However, a senior source told HSJ that despite the financial penalties for elective referral to treatment times being dropped, NHS Improvement was still heavily performance managing trusts on their performance.

When the STF was first introduced, the 30 per cent performance component was divided equally – 10 per cent each – between A&E, elective and cancer waits.

The most recent available performance data, for January 2017, shows 1,339 patients waiting more than 52 weeks for treatment on an elective pathway – if these had been fined at the standard rate of £5,000 per patient, commissioners would have received £7m in fines.

Twenty-four trusts will have performance penalties applied in the normal way after rejecting a control total as part of the STF process.

A spokesman for NHS Improvement said: ”In this year and next, 30 per cent of the £1.8bn sustainability and transformation fund is linked to trusts’ progress against performance standards. However, next year it will concentrate solely on urgent care, including incentives to encourage closer working between local health and social care organisations.

”We still expect trusts to meet the referral to treatment and the cancer constitutional standards which are important for patients. We will continue to monitor these through Single Oversight Framework.”

Trusts 'will not be fined for failing waiting list and cancer targets'