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.’