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A faulty production line

NHS England to overhaul waiting time targets

The NHS will simplify waiting time standards, including the 18 week target from GP referral to treatment and the four-hour A&E standard, in a bid to factor in effective primary care and prevent ‘gaming’ of waiting times.

The new measures, proposed by national medical director Sir Bruce Keogh will seek to develop the four hour A&E treatment standard to take account of primary care provision, which currently penalises hospitals in areas with better GP access by leaving A&Es to deal with more complex patients.

And hospitals will no longer have an 18 week ‘admitted’ or ‘non-admitted’ standard for GP referrals, which Sir Bruce says causes hospitals to get a ‘black mark’ for treating a patient after this point and causing hospitals to defer treating patients on long-term waiting lists, according to pilot scheme results.

Sir Bruce states: ‘The way the [four hour A&E wait] target is calculated means that hospitals in communities with good out of hospital and community services, such as primary care or urgent care centres, could perversely be penalised because they see fewer minor complaints.

‘As we begin implementation of redesigned urgent and emergency care services in various parts of the country later this year, we should consider how to include these broader services within our access standards, alongside a wider range of clinical measures.’

However, he adds that the 62-week waiting time target for cancer referrals should remain, despite hospitals increasingly struggling to hit standards as GPs are put under pressure to referand public health campaigns drive demand.

Responding, NHS England chief executive Simon Stevens said: ‘Having considered these recommendations, and discussed them with the secretary of state, we have decided to accept the recommendations in Bruce’s letter in full.’

Readers' comments (5)

  • Does it sound like the shifting of the goal posts.Do we now have a 62 week wait for cancer referals as well?Easy

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  • Just a human concept made up in some 'oh so special' persons mind. The 2ww target is important. The rest, indifferent as the sick will be eventually seen.

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  • Is this a very slight nod towards the complexity of issues meaning simple target driven outcomes do not make sense in healthcare?

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  • Vinci Ho

    Has anyone had a good look on these very complicated admitted , non-admitted and incomplete pathways and hence the targets for 18 weeks wait?They were created a few years ago and now the first two were supposed to be scrapped because they were 'perverse' targets.
    So tax payer money was spent to measure these targets which ended up being abolished . Just 'love' the job of these bureaucrats ......

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  • Keogh is managing down expectations and standards. The NHS is being transformed to the ludircous US Health Maintenance Organisation and private insurance model. The transition requires the dismantling of cost-effective and high quality public services to act as the driver for the Insurance industry which can not compete with the Beveridge system. The middle class flight to private insurance will be facilitated by transferable Personal Health Budgets.
    We are witnessing the cold and calculated destructiin of our world respected universal single payer health service to be replaced by skid row provision for the uninsured and the insured to the mercy of the insurance industry, experts in maximising profits through fleecing the worried well and denying expensive care to clients deemed unworthy for one arbitary reason or another.
    All these issues are exposed in Michael Moore's film 'Sicko' essential viewing for GPs wishing to see our future clearly.
    The NHS heist by corporations in the UK is explained at

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