Waiting times to increase in NHS England 'trade-off'

Patients will have to wait longer for non-urgent operations and go without some new drugs under new plans.

Simon Stevens, chief executive of NHS England, has revealed his blueprint for how the service will cope with huge clinical and financial pressures over the next two years.

The plans contain measures to deal with an ageing population and growing demand at a time when the NHS budget is under huge pressure and growing at the slowest rate in its 69-year history.

These include better coordinated local care, 150 new urgent treatment centres as an alternative to A&E, and extending GP services in an attempt to vacate up to 3,000 hospital beds.

Speaking to NHS staff at a heath centre in Aldershot, Mr Stevens said: "These are practical next steps we can take to improve health care for the people of this country.

"We get the fact this is a time of real pressure in the NHS, but there are things that we can be very proud of too."

Ahead of the announcement, Mr Stevens said the plans involved a "trade-off" that will see some waiting times increase, "hundreds of thousands" of patients no longer referred to hospital consultants, and new drugs not automatically prescribed.

The NHS target is for 92% of patients to be treated within 18 weeks of referral but this has not been met since February 2016.

Mr Stevens also acknowledged the national A&E target of 95% of patients waiting no more than four hours would not be met until the end of 2018.

It comes two months after the worst A&E performance statistics on record, with the traditional winter challenges exacerbated by the number of elderly patients waiting for social care occupying hospital beds.

Mr Stevens said: "We are saying that we expect that the number of operations that the NHS pays for will continue to go up, but we recognise that - right now about nine out of 10 people get their operations in under 18 weeks - in some parts of the country that will be under pressure.

"We do say here there is a trade off... we do expect there will be some marginal lengthening of waiting lists but this will still represent a strong, quick waiting times experience compared to 10 years ago, let alone 20."

Mr Stevens said the NHS had to adapt if it was to remain sustainable, but declined to comment on the level of funding.

In January, he said the Prime Minister was "stretching it" when she claimed the NHS had received more money than it had asked for.

Mr Stevens added: "What we are saying is that we have a health service that is bigger year on year.

"What we also recognise is that a combination of a growing and ageing population, the number of new treatments that are coming on and the rise in demand being experienced means that we have to make some choices."

"We accept that the 2017/18 budget for the National Health Service is fixed, and so we've set out what we intend to do within the budget that's available."

Under the plans, hospitals will also be incentivised to help people stop smoking.

Doctors' leaders and hospital trusts welcomed some elements of the plan, but said the NHS's challenges could only fully be addressed by more funding.

Dr Mark Porter, chairman of the British Medical Association, said: "It contains a lot of good provisions but the big problem is… that it doesn't provide an answer to the single crushing problem that permeates health and social care at the moment, and that's a deliberate long term chronic under-funding."

Shadow health minister Jonathan Ashworth MP said the waiting time increases were "a direct result of the financial crisis".

He said: "The collapse in standards in the past year has been nothing short of astonishing."