Source · Select Committees · Public Accounts Committee
Recommendation 9
9
Accepted
We asked NHSE about its optimism at the time it agreed the recovery targets.
Recommendation
We asked NHSE about its optimism at the time it agreed the recovery targets. It told us that its assumption about low levels of COVID-19 had turned out to be “completely wrong”. It added that this had resulted in both a higher than anticipated demand for hospital beds for patients with COVID-19 and higher staff sickness absence.18 The National Audit Office report states that the NHS is also managing other major pressures, 7 C&AG’s Report, paras 16, 3.12, 3.13, Figure 11, Figure 12 8 C&AG’s Report, paras 16, 1.8, 3.12, 3.13. 9 Quarterly data available at: https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2022/12/Cancer- Waiting-Times-National-Time-Series-Oct-2009-Oct-2022-with-Revisions.xlsx 10 C&AG’s Report, Figure 5. 11 Q 44 12 C&AG’s Report, para 16, 2.14 13 Available at: https://www.england.nhs.uk/wp-content/uploads/2022/07/B1881_Next-steps-in-the-recovery-of- elective-services_July-2022.pdf 14 Q 44 15 Committee of Public Accounts, NHS backlogs and waiting times in England, Forty-Fourth Report of Session 2021–22, HC 747, 16 March 2022 16 C&AG’s Report, para 3.2 17 C&AG’s Report, paras 14, 3.3 18 Q 11 10 Managing NHS backlogs and waiting times in England including other ongoing effects of the COVID-19 pandemic, access to primary care, the performance of urgent and emergency care, workforce gaps, and problems with the supply of adult social care.19
Government Response Summary
The government agrees to revisit planning assumptions and publicly report any updates to targets for cancer backlog, elective care waits, and the 18-week standard, with a target implementation date of Spring 2024, and states actions have been stepped up to tackle the backlog.
Government Response
Accepted
HM Government
Accepted
2. PAC conclusion: NHS England was over-optimistic about the circumstances in which the NHS would be trying to recover elective and cancer care. 2. PAC recommendation: NHS England and the Department of Health and Social Care should revisit their planning assumptions for the recovery and publicly report any updates to targets so that patients and NHS staff can see a clear and realistic trajectory to achieve the 62-day cancer backlog target, the 52-week wait target for elective care, and, ultimately, the 18-week legal standard for elective care. 2.1 The government agrees with the Committee’s recommendation. Target implementation date: Spring 2024 2.2 The department and NHS England have stepped up actions to tackle the backlog since the publication of the Delivery Plan for tackling the COVID-19 backlog of elective care. The ambitions in the delivery plan were agreed between NHS England and the government, based on detailed modelling and available funding at the time. The aim of setting stretching ambitions though to March 2025 was to ensure that patients, taxpayers and frontline staff had a shared and realistic expectation of progress towards recovering the backlog caused by the pandemic. The scope of the Delivery Plan’s targets reflected this aim. 2.3 Trajectories and planning assumptions for the commitments set out in the Delivery Plan are formally reviewed and revised annually through the operational planning process. In recognition of the additional pressures that the NHS is operating under since the publication of the plan, the government announced an additional £3.3 billion for the NHS in 2023-24 and 2024-25 in the 2022 Autumn Statement, enabling rapid action to improve emergency, elective and primary care performance. 2.4 The department and NHS England are committed to delivering the targets in the Delivery Plan and continue to work together to agree future ambitions. The NHS has delivered on the first of the ambitions, virtually eliminating long waits of over 104 weeks by July 2022 and is on track to virtually eliminate waits over 78 weeks, albeit the NHS is facing additional hurdles to delivery due to industrial action.