Wait for cataract and hip ops could get even longer
18-week target ‘might never be met again’
THE NHS target to treat patients within 18 weeks of being referred for routine surgery ‘won’t be met again’ and should be overhauled, health chiefs said yesterday.
They warned that many hospitals had already given up on targets for non-urgent surgery to focus efforts on A&E and cancer treatment.
The 18-week limit is stipulated in the NHS constitution, but patients must often wait much longer for treatment.
Now thousands more could face extended waits for routine procedures including hip and knee operations and cataract surgery after bosses called for the guidelines to be rewritten to reflect the mounting pressures facing the NHS.
They want the head of the NHS, Simon Stevens, to let hospitals concentrate on urgent treatment and cancer care in its forthcoming long-term plan. He has suggested the 18- week target could be amended to reflect ‘significant clinical practice changes’.
Speaking anonymously yesterday, the chief executive of one of England’s largest NHS trusts, said it was time to be ‘realistic’ and prioritise patients in terms of needs, rather than targets, concentrating on the three priorities of A&E, cancer and elective surgery. He added: ‘We need differential waiting lists, we need people who need to be treated within 18 weeks and people that can wait longer.
‘One of the biggest challenges, probably for the first time, is really having to make decisions between the three major priorities.
‘I’ve tried over the years to balance all three but I just can’t do that any more. I’m having to make really, really difficult decisions. So cancer, absolutely. But we are saying, effectively, “We will stop our elective programme”. We will never deliver 18 weeks ever again.’
The proposal was backed by the Royal College of Surgeons, which said NHS England’s review was a good opportunity to review existing performance standards. Chris Hopson, chief executive of NHS Providers, which represents hospitals, said: ‘Many hospital trusts are finding it difficult to deliver all the national performance targets, in A&E, cancer and elective surgery. Trusts rightly prioritise according to clinical need. In practice, given the pressures facing the service, this can mean slipping elective surgery performance despite potential adverse consequences for patients.
‘The NHS long-term plan must be ruthlessly honest about what can be achieved for the available money and what the priorities should be, including whether and how quickly we want to recover performance against the 18-week elective surgery target.’
Growing demand on NHS services caused by the rising and ageing population is putting pressure on hospitals and primary care.
Officials have warned that it is struggling to recover after the worst winter on record and the number of patients left waiting for an operation reaching 4.3million, the highest level in a decade.
Cancer waiting times have also fallen to their worst levels, with treatment delayed too long for thousands of patients.
The Government has promised the NHS more cash, but there is pressure for this to be spent on transforming services rather than a ‘sticking-plaster solution’ that will leave trusts facing the same problems every year.
But John Kell, of the Patients Association, said: ‘It will be difficult for patients to understand how waving the white flag on this target is compatible with a vision of an improved Health Service.’
Caroline Abrahams, of Age UK, said: ‘ Delaying surgery could cause a condition to worsen and make the operation more difficult. For older people it does not only condemn them to additional misery and pain, it can threaten their ability to live independently – a terrible price for anyone to pay.’
‘Terrible price for anyone to pay’