PM sets out plan to tackle hospital backlog

The back of a staff member in scrubs walking down a hall in a ward at Ealing Hospital in London
[PA Media]

More NHS hubs will be set up in community locations and there will be greater use of the private sector to help reduce hospital waiting lists in England, the prime minister says.

Sir Keir Starmer also promised to give patients more choice over where they get treated as he unveiled plans to tackle the NHS backlog.

The waiting list currently stands at 7.5 million with four in 10 already having waited longer than the target time of 18 weeks.

Sir Keir unveiled a new pledge to cut the list of patients waiting more than 18 weeks by nearly half a million over the next year.

Doctors leaders welcomed the plan, but expressed concern whether there was enough staff to achieve the goals being set.

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The plan includes:

  • Expanding the existing network of community diagnostic centres and surgical hubs so more treatment can be done outside of hospitals

  • Making it easier to exercise patient choice - this was introduced 20 years ago but only a quarter of patients believe they are offered a choice of where they get treated

  • A new deal with the independent sector so more NHS patients can get treated in private clinics with a particular emphasis on joint operations and gynaecological procedures

Sir Keir said: "NHS backlogs have ballooned in recent years, leaving millions of patients languishing on waiting lists, often in pain or fear. Lives on hold. Potential unfulfilled.

"This elective reform plan will deliver on our promise to end the backlogs.

On expanding use of the private sector, Sir Keir acknowledged "some would not like this".

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But he added: "I'm not interested in putting ideology before patients."

A key Labour election pledge, now included in the government's six main priorities, is for 92% of patients to begin treatment or be given the all-clear within 18 weeks by the end of this Parliament.

This has been an official NHS target for some time, but has not been met since 2015. Currently, only 59% of patients meet the 18-week target, with three million people waiting longer.

The new promise is to reach 65% by March 2026, which, according to the government, would reduce the backlog by more than 450,000.

The aim of the community diagnostic hubs is to get patients treated more quickly, closer to home and without relying on hospitals. Officials say these centres will provide up to half a million extra appointments each year.

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GPs will also be able, where appropriate, to refer patients directly to these centres without requiring a prior consultation with a specialist doctor.

More surgical hubs will be created to focus on common, less complex procedures, such as cataract surgeries and some orthopaedic work. These hubs are ring-fenced from other parts of the hospital to ensure operating theatre time is not lost if there are emergency cases.

The new plan also says that one million unnecessary appointments per year will be freed up for patients who need them. This will be made possible by abolishing automatic review appointments after treatment and only offering them to patients who request them.

Officials say the extra appointments created will be in addition to what was promised by Labour before the election. That pledge was for 40,000 more appointments per week, or two million a year, to be created within the first year.

This compares with a normal annual total of more than 100 million appointments. Ministers have confirmed that work on this pledge began soon after the election.

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Plans for patients to use the NHS App to monitor and book consultations and test results, with greater control over where they are treated, have already been announced. The goal is to make the system more efficient and reduce the number of missed appointments.

NHS England Chief Executive Amanda Pritchard said: "The radical reforms in this plan will not only allow us to deliver millions more tests, appointments, and operations, but do things differently too – boosting convenience and putting more power in the hands of patients, especially through the NHS app."

The overall waiting list for NHS appointments, procedures, and surgeries in England stands at just under 7.5 million.

No target level has been set in the plan, but ministers say that the waiting list will inevitably fall as measures to meet the 18-week benchmark take effect.

The funding for NHS England has been set for the upcoming year, but the additional money needed to support extra activity in hospitals will be outlined in the government's spending review later this year.

Frustrated

Professor Phil Banfield, of the British Medical Association, expressed doubt over whether the plan could be delivered.

"Doctors have been just as frustrated as their patients by the lack of facilities to deliver care and want to bring waiting lists down," he said.

"But the reality is that without the workforce to meet constantly rising demand, we will not see the progress we all hope for."

Prof Banfield's concerns were echoed by Dr Jeanette Dickinson, Chair of Council of the Academy of Medical Royal Colleges.

"We know that these things can make a difference, we know that these have been tried in small areas, piloted, and do make a difference," she told the BBC's Today programme.

"It's doing it at pace and at scale, having the staff available, having the estate available, the operating theatres, the consulting rooms, the capacity to deliver those changes."

Ed Argar, Shadow Health and Social Care Secretary, said it was the Conservatives who "revolutionised" the diagnostic process by rolling out 160 community diagnostic centres.

He said the government's plan is "another announcement that makes clear after 14 years in opposition, the Labour Party have no new ideas of their own for the NHS – despite promising change".

"Patients cannot wait for more dither and delay from the government who promised so much, and so far have delivered so little," he said.

Liberal Democrat MP and health spokesperson Helen Morgan said the plan for waiting lists could risk "putting hip replacements over heart attacks", unless the "crises" in emergency and social care were addressed.

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[BBC]

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