Healthcare experts from the Nuffield Trust are calling on the next government to approach the issue of waiting lists differently, after research suggested that nine out of 11 targets set out in the NHS Constitution are not currently being met.
The think tank says the last time the majority (six out of the then 10) of the targets were met was in 2015, with the health service never meeting all its targets at once — even accounting for previous ones.
Analysis funded by the Nuffield Foundation indicated that targets on diagnostic care and A&E waiting times have not been met since 2013 and 2015 respectively — the latter is also the last time cancer referral to treatments targets were met.
The target that 92% of treatments should be started within 18 weeks has been missed every month since February 2016.
The only targets that have been met are talking therapy ones, which have been supported by staff and investment injections, as well as early intervention in psychosis, where the target has been repeatedly delayed or moved downward.
The Nuffield Trust highlights that focus has been misplaced on trying to achieve targets without delivering the requisite money, capacity or efficiency — this has been a distraction from policies that could enact actual change, such as bolstering out of hospital services and funding for estates and equipment.
In the fourth of a series of briefs from the think tank ahead of the 4 July general election, policymakers are being urged to stay away from the temptation of new targets while existing ones are being missed.
Instead, the Nuffield Trust calls on the next government to:
- only commit to new targets when there is sufficient funding or an evident plan to improve efficiency;
- prioritise community and mental health services;
- spend equal amounts of buildings and equipment as comparable countries, while putting an end to capital budget raids;
- reduce short-term funding pots for improvement; and
- avoid detailed top-down targets that ignore local variation.
“The British public are seriously dissatisfied with NHS waits, and political parties are clamouring to convince them they have the solutions,” said Mark Dayan, Nuffield Trust’s head of public affairs.
He added: “But we have seen year after year that ambitious targets and commitments fall flat unless there is enough money, staff, and capacity across the entire health and care system to actually make them happen.
“We need to learn from the long history of waiting times getting better and worse in the NHS that what works is realistic plans you stick to over time, not lots of panicky short-term pots of money.
“The next government will need to direct funding away from filling budget holes and into a multi-year campaign to repair buildings, equipment, and out-of-hospital services – as has been accepted for years but never delivered.”
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