Waiting times for patients in need of hip and knee operations will grow as cash-strapped hospitals prioritise A&E and cancer services, the NHS has admitted.
Health service leaders yesterday accepted that the Government target that nine out of 10 patients should wait no longer than 18 weeks for non-emergency operations would be widely missed until well into 2018, having not been met since February last year.
Doctors’ leaders said the 18-week target has been “jettisoned in all but name”, however the NHS denied the policy was being formally dropped.
It’s a long-standing principal of medicine that you treat the patients with the most urgent need first
Simon Stevens, Chief Executive NHS England
Announcing the NHS’s strategy over the next two years, Chief Executive Simon Stevens said an expected rise in waiting times for routine procedures, which also include cataract removal, hernia operations and laparoscopies was a “trade off” for improvement in other areas, such as hitting the four-hour A&E target, better cancer care mental health services.
The Government attracted heavy criticism this winter when it emerged January was the worst month on record for A&E departments, with more patients than ever waiting longer than the politically significant four-hour target.
Mr Stevens said yesterday said he aimed to “get the patient experience of A&E back on track” as soon as possible.”
“We do expect, and we say here, that there is a tradeoff, we do expect that there will be some marginal lengthening of waiting lists,” he said, adding that waiting times for routine surgery still compared favourably to 20 years ago.
“It’s a long-standing principal of medicine that you treat the patients with the most urgent need first.
"That’s the principle that we’re applying here.”
The two-year blueprint also revealed hundreds of thousands of patients would no longer be referred to a consultant by their GP.
Family doctors will instead be encouraged to phone consultants to ask for advice, while other measures will be put in place to cut the number of people needing to be sent to hospital for care.
As part of the new framework, funding for hospitals will now be dependent on the efforts staff make to persuade drink and drug users to seek treatment while they are on the premises.
“There is going to be an incentive for hospitals to have a quiet word because the evidence shows that if you've had a heart attack or are in hospital for something, that's actually the moment when people are willing to think about making changes to their lifestyle,” said Mr Stevens.
The Royal College of Surgeons welcomed aspects of the new report, but criticised the position on non-urgent surgery.
“We fully appreciate the pressure in the NHS and how in the current financial climate it is not possible to prioritise and fund everything,” said Miss Clare Marx, the college president.
“Nevertheless, it will be difficult for the general public to understand how waiving the white flag on the 18-week target is compatible with a vision of an improved health service.”
Chris Hopson, Chief Executive of NHS Providers, which represents the hospital sector, said: “The plan reinforces a simple, stark, truth: that you get what you pay for.
"Trusts will do all they can to transform and realise efficiencies as quickly as possible.
"But if NHS funding increases fall way behind demand and cost increases, NHS services inevitably deteriorate. That is clearly now happening."
NHS England yesterday also announced 'Nurse First', a scheme to fast-track graduates into a career in nursing.
The proposal, inspired by the successful Teach First initiative, aims to lure high-achieving individuals by the promise of paid-for training and accelerated promotion.
Aspiring nurses must currently pass a three-year nursing degree, however under the new pilot those who already have a degree in another subject will undergo a shorter “top-up” course of no longer than two years.
Once practising, they can expect to reach leadership positions within five to seven years.
Professor Jane Cummings, Chief Nursing Officer for NHS England, said the scheme would enable “highly skilled” existing graduates to become “very strong clinical leaders in the future”.
She revealed yesterday that the first batch would be drafted into mental health nursing rolls, and those caring for patients with learning difficulties.
NHS England plans to pilot the scheme later this year.