NHS patients receiving letters days after their appointments, admits Steve Barclay

NHS patients are missing appointments because letters informing them of their slot are arriving days after the consultations were due to take place, the Health Secretary has admitted.

In an interview with The Telegraph, Steve Barclay cites the problem as one of a series of inefficiencies that would be eliminated by a mass rollout of electronic booking via the NHS app. He wants all patients to be able to secure, and reschedule, medical appointments just as easily as they could book or change timeslots for Covid vaccinations. “We’re working on that,” he says.

In his former role as the Treasury minister responsible for providing value for taxpayers’ money, Mr Barclay seldom held back his views on the need for greater NHS efficiency.

For almost a year, he has had the opportunity to put his approach into action as the Secretary of State in charge of overseeing the health service at a time when its budget amounts to more than 40 per cent of day-to-day spending on public services and many patients are expressing frustration over long waits and appointments.

He hopes that the rapidly growing use of the NHS app will reduce missed appointments. “The app provides that gateway, when you make the appointment, you then have the facility to change it. As you make that appointment, it goes into your diary, the text message reminder can then be sent as opposed to getting the letter days after an appointment.

“And it’s using tech to cut the waiting list because you’re not having so many appointments lost with ‘do not attends’ as at the moment.”

'Value for money'

Visiting West Suffolk hospital, which is benefiting from the Government’s refurbishment programme, the 51-year-old Health Secretary peppers his description of his plans with references to “patient choice” and “value for money”.

The Conservatives are conscious of the electoral consequences of being seen to have let NHS spending balloon out of control without a parallel rise in the quality of services. Cutting waiting lists is the third of the Government’s five stated priorities.

Mr Barclay, a former lawyer at Barclays who has become a close ally of Rishi Sunak, says his approach includes using technology to identify the hospitals clearing Covid backlogs most efficiently and replicating their approaches at under-performing trusts. He also wants patients to be able to book, and reschedule, medical appointments easily.

“It’s important, as we deal with the challenges of the pandemic, that we embrace the innovation and the pace that we saw during the Covid period itself, and that we don’t move back to doing things as we did before,” he says.

“I think tech is a key enabler for staff in terms of reducing some of the very real workload challenges that they face. And the pandemic in particular, has put huge pressure on staff.

“But also for patients, if we’re able to deliver care to them quicker, that delivers much better patient outcomes – but is also usually better value for money, as well.”

Rising number using NHS app

A redesign of the NHS app, for which six million users registered in the past year, has led to a jump in the number of appointments and repeat prescriptions being secured via the digital service.

During the pandemic, many patients were able to book an appointment for a Covid vaccine by simply clicking a link and then choosing a time-slot, which they could change closer to the time if needed.

Mr Barclay also wants to make greater use of private hospitals to help reduce NHS waiting lists – an issue on which he claims Labour is split.

Mr Barclay, who was chief secretary to the Treasury under Boris Johnson, kept a tight rein on public spending and was appointed as chief of staff by the then prime minister in a bid to settle backbenchers’ nerves.

Mr Barclay was initially appointed as Health Secretary by Mr Johnson following the resignation of Sajid Javid in July last year, before being sacked by Liz Truss and reinstated when Mr Sunak became Prime Minister in October.

“One of the first things I did when I joined the department was we brought in a number of data software engineers who have been building capability around the real time data. That allows us to see in much quicker time variation in performance. And then that allows us to focus in on that variation, which is a key way of addressing waiting times,” he said.

Debate on international recruitment

Mr Barclay, who campaigned for Leave in the 2016 Brexit referendum, has found himself privately advocating for a continued relaxation of visa restrictions on medics coming from overseas, in order to plug gaps in the NHS. But he appears to agree with NHS trusts that warned a little over a week ago that the current reliance on overseas staff is becoming unsustainable.

“In the short term, there needs to be international recruitment because of the immediate challenges that we face,” in the form of the Covid backlogs, he says. But, he adds: “There’s a recognition we need to train more domestically, not least because globally, it will become over time more competitive to attract workforce. When I was in Japan, with the G7 health leaders, all countries are facing workforce pressures.”

The NHS workforce plan, due to be unveiled next month, is expected to set out proposals to increase the number of homegrown medics to avoid a looming shortage of more than half a million workers.

The proposals will include boosting training “both through the traditional routes of university, but also more vocational training, and more apprenticeships”.

Mr Barclay is less eager to discuss the role that pay plays in the health service’s ability to recruit and retain medics. He is currently at loggerheads with the Royal College of Nursing and British Medical Association over pay for nurses and junior doctors, having agreed a rise for more than one million other NHS workers.

Wage rise of 49pc not 'fair and reasonable'

The BMA has been demanding a 35 per cent pay rise to make up for what it estimates to be a 26 per cent fall in the real-times value of doctors’ salaries since 2008. Would Mr Barclay like to be able to give doctors more than his current offer of a 5 per cent increase, in order to boost the number working in the NHS?

“Well, I hugely value the contribution made by doctors and recognise the huge pressures, particularly from the pandemic, but also from a growing older population ... That is why we made a fair and reasonable offer to them. I don’t think a demand of 35 per cent – and indeed, in the negotiation that increased to 49 per cent – is fair and reasonable to taxpayers.”

Mr Barclay suggests that while “pay is important”, the NHS can become a more attractive place to work as a result of a technological overhaul and investment in new infrastructure.

Last week Labour claimed that the Government will not meet its manifesto pledge to build 40 new hospitals this decade, after Mr Barclay admitted to delays in the flagship NHS building programme.

He is prioritising hospitals such as West Suffolk, which have significant amounts of a lightweight type of concrete with a limited lifespan.

Mr Barclay says a shift to “one standard design” for new hospitals had made “the internal government process much smoother and quicker, because you’re not running an assurance programme on individual, different designs”.

He adds: “When you’re sitting in the Treasury, you’re thinking these are things that could help save money.”