‘Damaging’ NHS targets ‘have had their day’ claims Lord Prior

NHS targets “have had their day” according to Lord Prior as the head of the health service launches an attack on 25 years of flawed health policies.

On the same day A&E performance slumped to the worst level on record, NHS England’s chairman has signalled plans to abolish key performance targets, suggesting that they damage patient care and encourage “gaming” by NHS trusts.

Criticising what he called a dysfunctional system, the former health minister told a conference: “We have had 15 years of this top-down, target-driven culture that has driven the NHS.

“The degree of pressure to hit targets is something I have never encountered in the private sector, the unnuanced level of these targets.

“They have encouraged this top-down, hierarchical control in the NHS which has been very damaging for the culture, and very bad for getting clinicians involved and engaged.”

Lord Prior said he believed “targets have had their day” and has led to the development of gaming around these targets.

“Go to any A&E department and everyone measures the time… you get to three hours 55 minutes and all hell hits. Everyone runs around like headless chickens to get them out or get them through or discharge them before the four hours.”

His comments come as the latest NHS performance figures revealed that A&E departments saw 84.4% of patients within the flagship four-hour target, the lowest since it was introduced in 2004.

The NHS hasn’t met the four-hour target since 2015, and the new figures equate to around 84,000 patients in January waiting over four hours for a bed.

Rachel Power, chief executive of the Patients Association, said it was “a sad indictment of the state of our health service” that thousands of patients were left facing the prospect of being stranded.

Nuffield Trust’s chief economist John Appleby said the NHS was “fighting a losing battle” in its efforts to provide timely healthcare; and NHS Confederation said the figures show that the NHS is “buckling under the strain.”

NHS England is currently reviewing its clinical targets, including the 95% target for all patients attending A&E to be seen with four hours.


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