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Jeremy Hunt revises NHS performance targets to remove 'perverse incentives' Jeremy Hunt revises NHS performance targets to remove 'perverse incentives'
(about 1 hour later)
The health secretary, Jeremy Hunt, has outlined changes to the way the results of controversial performance targets such as waiting times for A&E and cancer treatment are published. Two key NHS waiting time targets are to be abolished and the way in which performance results are reported will be overhauled, the health secretary, Jeremy Hunt, has announced. He said a “much more consistent approach” was needed.
Hunt, speaking at the NHS Confederation’s annual conference in Liverpool, agreed a “much more consistent approach” was needed to make sense of the figures and ensure they are helping patients. Speaking at the NHS Confederation’s annual conference in Liverpool, Hunt referred to a letter written by NHS England’s national medical director, Sir Bruce Keogh, which said a “confusing set of standards” was leading to “perverse incentives” regarding the 18-week target for patients to receive treatment from the date they are referred by their GP.
He referred to a letter written by NHS England’s national medical director, Sir Bruce Keogh, which said a “confusing set of standards” was leading to “perverse incentives” regarding the 18-week target for patients from when they are referred by their GP to when they receive treatment. He suggested two out of three parts of the 18-week referral-to-treatment times (RTTs) be abolished. They are the target for 90% of patients who need treatment to be given it within 18 weeks, and the target for 95% of people needing outpatient appointments to be seen within 18 weeks. The target for 92% of all patients to be seen within 18 weeks will not be scrapped.
He suggested two out of three parts of the 18-week referral to treatment time (RTT) be abolished while recommending a pilot testing the effectiveness of an eight-minute deadline for ambulances to respond to emergency calls be extended. He said a pilot testing the effectiveness of an eight-minute deadline for ambulances to respond to emergency calls should be extended.
His recommendations have been accepted by the NHS, and other changes will mean that A&E, cancer and RTT targets – which were published at different times either weekly, monthly or quarterly – will now be released together each month. His recommendations have been accepted by the NHS, and other changes will mean A&E, cancer and RTT waiting time targets – which were published at different times either weekly, monthly or quarterly – will now be released together on one day each month.
NHS England said the two indicators being scrapped penalised hospitals for treating patients who had waited longer than 12 weeks, while the one that will remain is the only measure that captures the experience of every patient waiting. The shadow health secretary, Andy Burnham, said Hunt’s announcement demonstrated that the NHS was “going backwards under David Cameron and waiting lists are at a seven-year high”.
Responding to the announcement, the shadow health secretary, Andy Burnham, said it demonstrated the NHS is “going backwards under David Cameron and waiting lists are at a seven-year high”. He said: “Patients will wonder how scrapping these standards will help improve that situation. The government should be trying to get things back on track and ensure patients have quicker access to treatment, rather than focusing on moving the goalposts.”
“Patients will wonder how scrapping these standards will help improve that situation,” he added. “The government should be trying to get things back on track and ensure patients have quicker access to treatment, rather than focusing on moving the goalposts.” The latest figures from NHS England show that the target of giving 90% of admitted patients consultant-led treatment within 18 weeks of referral was missed in nine of the last 12 months.
Labour said one of the targets being scrapped, the admitted adjusted target – that 90% of admitted patients should start consultant-led treatment within 18 weeks of referral – has been missed for nine out of the last 12 months. Speaking during a Commons debate on the government’s new “success regime” – under which NHS regulators this week have taken control of three regions where hospitals are failing – Burnham said: “During this exchange, news has reached me that the secretary of state is in Liverpool announcing the scrapping of the 18-week target, presumably because they know they can no longer meet it.”
Hunt told delegates the NHS is facing “a very, very challenging period in its history”, before setting out a series of changes he wanted to see. It was announced on Wednesday that NHS regulators would intervene in three areas of England – Essex, north Cumbria and north, east and west Devon – to dictate how local services tackle longstanding problems such as understaffing, financial trouble and poor care.
“Most of these efficiencies are going to take a huge amount of effort from the people in this room,” he said. “Bruce Keogh today has written a very important letter that points out the inconsistencies in the way we publish performance data with A&E figures published weekly, RTT monthly and cancer quarterly. Related: Regulators to take over NHS services in three English regions
“And he has said that we need to have a much more consistent approach, published all monthly on the same day, and also include the safety statistics in that. And that way I think we can have much more consistency in the way we report performance.” Burnham demanded to know why the “success regime” announcement, which he said had serious implications for patients, was not made to MPs in parliament. “It was being finalised on Tuesday when this house was engaged in a full day’s debate on the National Health Service and yet there was not one single mention of it in the course of that debate,” he said.
While 95% of patients who go to A&E are meant to be admitted, transferred or discharged within four hours, the target had been missed for 33 consecutive weeks until the most recent figures came out on Monday, when it was hit for the first time since September. “What are we to make of that Mr Speaker? And why is the secretary of state not here to give this announcement to this house? Why does he think it’s always more important to make announcements in TV studios or to outside conferences than it is to members in this house.”
The different targets were brought in under the Labour government a decade ago and have proved to bring down waiting times overall. The health minister Benedict Gummer, who responded to the urgent question from Burnham in the absence of Hunt, accused the shadow health secretary of ignoring the welfare of patients and using the NHS for “his own political reasons”.
“It is a shameless attack, which I do think reflects rather badly on himself and not on the cause that he should seek to pursue which is the better care of patients,” said Gummer.
“It is absolutely extraordinary that once again we have the shadow secretary of state coming here, speaking again and again and again about structures, about the NHS and its bodies, about jobs, about providers, about deliverance, but not about the people who are being failed at a local level and that is patients in Essex, west and north-east Devon and in north Cumbria.”
Gummer said the purpose of the success regime was to “improve health and care services for patients in local health and care systems that are struggling with financial and quality problems”.
He said the plans were being drawn up and coordinated by local commissioners and not by “monolithic centralised bodies”, as was Labour’s impulse in government, he alleged.