The pledges made as part of the Labour Party manifesto will not be enough for the new government and NHS to achieve the 18-week referral to treatment target (RTT), new research from the NHS Confederation indicates.
The Department of Health and Social Care says it wants to hit the 92% RTT target – a target that has not been met since early 2016 – by the end of this parliament by delivering an additional 40,000 NHS appointments a week (or two million a year).
This will be enabled through:
- Waiting list collaboration in neighbouring hospitals
- The independent sector
- Staff being incentivised to work extra evenings and weekends
Analysis
New analysis from the NHS Confederation suggests, however, that, if the government were to only rely on its manifesto pledges to meet the 2028/29 target, it would only account for around 15% of the requisite activity. This is also factoring in the expected growth in demand (3.8% annually on average).
The report concludes that the NHS will need to deliver 33.6 million outpatient appointments, four million day-case procedures, and 1.1 million overnight stays to cut the waiting list back to levels that would be conducive to meeting the 18-week RTT target by the end of this parliament – this is 50% more activity than being delivered now.
For context, the NHS accrued 22.2 million outpatient appointments, 2.8 million day-case procedures, and 740,000 overnight stays during 2023/24.
“NHS leaders share the government’s ambitions to restore performance on the 18-week target by the end of this parliament,” said the NHS Confederation’s CEO, Matthew Taylor.
He added: “But to achieve this the government will need to use the Autumn Budget to deal with the short-term deficit that is leading to NHS organisations either cutting or freezing posts.
“This will inevitably impede efforts [sic] increase productivity and reduce the waiting list. As our analysis with CF shows, 40,000 extra appointments a week won’t be nearly enough to hit the target.”
Recommendations
The NHS Confederation report argues that harnessing the power of the Federated Data Platform more widely to enhance efficiency and accuracy, while also supporting staff to adopt digitally enabled practices for the elective pathway is the way forward.
The organisation estimates that, if everyone on the waiting had their reason for treatment validated, approximately 770,000 pathways would be removed – the equivalent of around 10% of the 7.6 million-strong overall waiting list.
The report also calls for elective hub capacity to be doubled in hospitals that do not take on emergency care.
The NHS Confederation says that, to fully draw upon the benefits of these hubs and to meet future demand, an extra 730 theatres and 3,800 beds would be needed at ‘cold’ sites.
For this to come to fruition, capital funding along with “streamlined decision-making” would be required – the NHS Confederation has long been calling for an increase in the amount of capital funding the NHS in England receives.
This, in turn, would free up capacity at ‘hot’ sites for centres of expertise for complex elective admitted care. The NHS also says that outpatient care would benefit from adopting process automation, AI and robotics.
“Ultimately, we know that in order to keep up with the healthcare needs of the population the NHS needs reform, not just ever more activity,” said Matthew Taylor.
“This means shifting to earlier, more preventative services – including primary and community care – to slow the rise in demand for healthcare. It will also mean boosting productivity through using modern technology and having buildings and equipment that are fit for the 21st Century.”
Read the latest edition of the National Health Executive digital magazine to hear exclusive insight from the NHS Confederation’s CEO, Matthew Taylor, on the opportunities available via the New Hospital Programme pause.
Image credit: iStock
