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NHS targets to be scrapped to free trusts from 'bureaucratic burden'

NHS treatment targets are set to be scrapped in reforms designed to free trusts from a ‘bureaucratic burden’

  • Former health secretary is expected to complete review into NHS care in March
  • Officials expect it could recommend the health service is run more like schools
  • Ministers believe the NHS has become ‘overly centralised’ with too many targets

NHS targets could be scrapped next year in a bid to reduce the ‘bureaucratic burden’ slowing patient care, according to reports.

Disgraced former Labour health secretary Patricia Hewitt is expected to complete her review into NHS care in England by March.

Officials expect it could recommend the health service is run more like schools, with local health leaders handed greater control over how they manage workload.

Ministers believe the NHS has become ‘overly centralised’, leading doctors and trusts having to meet too many different targets, according to the i newspaper.

More than 7.2million patients in England were stuck in the backlog in October (red line)— or one in eight people. More than 400,000 have queued for at least one year (yellow bars)

A&E performance worsened in November, with a third of emergency department attendees not seen within four hours (red line) — the NHS’s worst ever performance. Thousands weren’t even seen after waiting in casualty for 12 hours (yellow bars)

Instead, the government would rather run the NHS ‘more like we do the schools system’, giving increased responsibility to set and meet goals at local level.

It comes as NHS England set hospitals a new objective of seeing three-quarters of A&E patients within four hours, effectively downgrading an official target of 95 per cent.

NHS England bosses told hospitals they should aim to see 76 per cent of all patients within four hours by April 2024.

It is part of new ‘planning guidance’ for next year, aimed to bring down record waiting lists of 7.2million patients and reduce waiting times at A&E.

Announcing Miss Hewitt’s role last month, Chancellor Jeremy Hunt said she will help him and Health Secretary Steve Barclay on operating new ‘integrated care boards’, which replaced clinical commissioning groups (CCGs) earlier this year.

Miss Hewitt, who held four frontbench roles under Tony Blair, faced a tumultuous two years as health secretary due to the introduction of a controversial junior doctor application scheme and slashing NHS spending to balance the books. Her achievements included implementing the ban on smoking in public places.

She was also suspended from the Labour Party in 2010 over political lobbying irregularities, and was forced to apologise over her links to a paedophile lobby group in the 1970s.

Yesterday, GP leaders welcomed the concept of fewer targets, warning that some of the 70 plus performance indicators felt like ‘tick-box exercises’ that were detracting from frontline care.

Professor Kamila Hawthorne, chair of the Royal College of GPs, said: ‘GPs and our teams are working under intense workload and workforce pressures and the bureaucratic burden we face on a daily basis is adding to this.

She added: ‘So, at the very least, a radical review of these in general practice is needed to ensure they are proportionate and extensively reduced – enabling GPs to focus on the needs of patient in their local areas – and are in the best interests of patients.’

Ambulances took an average of 48 minutes and eight seconds to respond to372,326 category two calls, such as heart attacks, strokes burns and epilepsy (red bars). This is nearly three times as long as the 18 minute target but around 13 minutes speedier than one month earlier

Cancer performance data shows that just six in 10 cancer patients started treatment in October within two months of an urgent referral from their GP (red line). The figure is the second-lowest logged since records began in 2009. NHS targets set out that the figure should be at least 85 per cent. It means 5,728 people waited more than eight weeks to start cancer treatment (blue bars)

Meanwhile, new NHS operational planning guidance includes a pledge for all heart attack and stroke patients to get an ambulance within 30 minutes, down from highs of an hour this summer.

The formal standard for A&E remains that 95 per cent of patients should be either admitted, transferred or discharged within four hours, but it has not been met since 2015.

NHS data for last month showed that 69 per cent of patients were seen within four hours of arriving at hospital.

Just 13 of 106 trusts saw at least 75 per cent of all attendances within four hours, including just four at type one major A&Es, the Health Service Journal reports.

Saffron Cordery, interim chief executive of NHS Providers, which represents hospitals, said: ‘Against a backdrop of severe operational pressures exacerbated by workforce shortages, care backlogs and soaring demand, trust leaders are bracing themselves for another tough year.’

Matthew Taylor, chief executive of the NHS Confederation, said: ‘No one should be under any illusions that 2023 will be one of the most challenging years the NHS has ever faced.’ 

Shadow Health Secretary, Wes Streeting, said scrapping targets would be ‘a disgrace’.

He said: ‘After years of failing to meet basic standards for patients, the Government is now looking to water down or scrap standards altogether. The answer is cutting waiting times, not cutting standards for patients.

‘It is a disgrace that patients are spending 24 hours in A&E, suspected heart attack and stroke victims are waiting around an hour for an ambulance, and that patients have waited longer for cancer care every year since 2010.’

In other related news… 

Hundreds of elderly Brits are to be checked for dementia through new pilot scheme in 2023 

Forgetting presents, not turning the oven on and getting lost in a relative’s house could be signs that a loved-one could has dementia, the NHS says

One in four elderly Brits fear they will have to resort to DIY dentistry as top dentist hits out at ‘broken’ system 

Why IS the NHS struggling this winter?

Bed blockers

Some 13,000 hospital beds across the country — or one in seven — are currently filled with patients declared fit for discharge. 

The figure is triple the pre-pandemic average.

And there is huge variation across the country. In London, half of patients were discharged on time but the figure was as low as 28 per cent in the North West. 

Experts say the numbers are being driven by a separate crisis in social care, leaving patients left to languish on wards for up to nine months because there is no suitable nursing accommodation or care available for them in the community. 

The lack of beds has seen ambulances stuck in queues for 20 hours outside of hospitals this summer, as emergency medics scramble to find beds for patients. This is had a knock-on effect on response times. 

Workforce shortages

The NHS, which employs over a million people, has around 130,000 vacancies across its entire workforce.

This reduces productivity, with too fewer staff to carry out appointments and procedures.

Health chiefs also warn that it stops staff from delivering high-quality care and can lead to safety concerns if too few staff are working.

In turn, medics are at a higher risk of burnout, illness and early retirement due to these factors. 

Surge in seasonal viruses 

More than 1,000 beds per day are taken up by patients severely unwell with seasonal viruses. 

NHS data shows Britons sickened with influenza occupied 712 beds, on average, each day last week. Flu levels are much higher than this time last year.

Meanwhile, norovirus accounted for 318 taken beds per day and RSV saw 132 occupied. 

Strep A fears

Nine children in the UK have died in recent weeks due to an outbreak of Strep A.

The bacterial infection is harmless for the vast majority. But it can cause life-threatening illness if the bacteria invade the blood, muscles or lungs.

Doctors have warned that A&E, GPs and ambulances are in meltdown due to a surge in demand from parents worried that their child is infected.

Patients have faced longer emergency department waits, while some hospitals have postponed routine procedures to cope with demand.

Covid pressures

Around 4,700 beds per day were occupied by a patient infected with Covid in the week to November 30.

Two-thirds were primarily admitted for another ailment, such as a broken leg, but happened to test positive.

However, infected patients still pile pressure on the health service as they have to be isolated from others.

The virus also contributes to higher rates of staff sickness.  

GP appointment crisis

Campaign groups, MPs and senior medics say desperate patients are turning to emergency and walk-in services because they can’t get a face-to-face appointment with their GP.

The average GP in England is responsible for 2,200 patients now – up from 1,900 in 2016. 

In the areas with poorest access, up to 2,600 patients are fighting over one family doctor.

The Royal College of Emergency Medicine (RCEM) has previously warned difficulties in seeing a GP was leading to a crisis in emergency departments.

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