Thirty-Eighth Report - Managing NHS backlogs and waiting times in England — Select Committees

2 Accepted

NHS England was over-optimistic about the circumstances in which the NHS would be trying to...

Recommendation

NHS England was over-optimistic about the circumstances in which the NHS would be trying to recover elective and cancer care. In our first report on NHS backlogs and waiting times in March 2022, we reported our concern that “officials are … Read more

Government Response Summary

The government agrees to 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.

HM Treasury

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3 Accepted

NHS funding has increased, but to deliver key priorities such as elective and cancer recovery...

Recommendation

NHS funding has increased, but to deliver key priorities such as elective and cancer recovery it will need to be spent in the most cost-effective way. The Department has allocated £14 billion to NHSE from 2022–23 to 2024–25 specifically to … Read more

Government Response Summary

NHS England will write to the Committee before summer recess to set out further detail on how funding available for elective recovery will be spent, together with details of its evaluation plans and initiatives to improve productivity.

HM Treasury

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4 Accepted

NHS England’s elective recovery programme partly relies on initiatives which have potential but for which...

Recommendation

NHS England’s elective recovery programme partly relies on initiatives which have potential but for which there is so far limited evidence of effectiveness. NHSE has expanded some programmes because it believes them to be sufficiently promising, but there is currently … Read more

Government Response Summary

The government agrees to describe the real-world impact of community diagnostic centres, surgical hubs, increased use of the independent sector, and the advice and guidance programme and write to the committee before the summer recess to give further details.

HM Treasury

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6 Accepted

The NHS’s recovery cannot succeed without comprehensive, realistic and sustainable plans for the future of...

Recommendation

The NHS’s recovery cannot succeed without comprehensive, realistic and sustainable plans for the future of the workforce and the capacity of adult social care. The Royal Colleges of Radiologists, Surgeons, Nursing, Obstetricians and Gynaecologists, and Ophthalmologists all submitted evidence to … Read more The NHS’s recovery cannot succeed without comprehensive, realistic and sustainable plans for the future of the workforce and the capacity of adult social care. The Royal Colleges of Radiologists, Surgeons, Nursing, Obstetricians and Gynaecologists, and Ophthalmologists all submitted evidence to us stressing the need for strategic workforce planning. In our March 2022 report on NHS backlogs, we stated that “the NHS will be less able to deal with backlogs if it does not address longstanding workforce issues”. Deferring action on this means not making the best use of the NHS’s existing hardworking and committed frontline staff. It is also clear that the success of the recovery programme is reliant on realistic long-term planning in other areas of health and care, including the capacity of adult social care where this is reducing flow through hospitals. The Department confirmed some of the steps it will take immediately, including to publish an independently verified forecast of the number of health professionals the NHS requires during 2023 and to allocate additional funds to improve hospital discharge into adult social care. These are not end-points, however, and results of this work must be incorporated into realistic planning assumptions for NHS elective and cancer recovery. Recommendations: • The Department of Health and Social Care should work with NHS England to reassess the achievability of elective and cancer recovery targets following the publication of its workforce plan in 2023, and planned improvements to the discharge of patients into adult social care. It should write to us as soon as possible describing the conclusions of this achievability assessment. • The Department should publish the underlying assumptions of its workforce projections alongside the forecasts in the workforce plan. This should include quantification of key assumptions, particularly on productivity, domestic training and overseas recruitment and, in full, the independent reviewer’s ass Show less

Government Response Summary

The government agrees to work with NHS England to reassess the achievability of elective and cancer recovery targets following the publication of its workforce plan in 2023 and the planned improvements to discharge of patients into adult social care and to publish the underlying assumptions of its workforce projections.

HM Treasury

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7 Accepted

In July 2022, the Chief Executive of the NHS, wrote to all Chief Executives of...

Recommendation

In July 2022, the Chief Executive of the NHS, wrote to all Chief Executives of NHS trusts, NHS Foundation Trusts and Integrated Care Boards stating that the 62-day cancer backlog target should be a critical priority for the remainder of … Read more

Government Response Summary

The government agrees to revisit planning assumptions for recovery and publicly report any updates to targets for the 62-day cancer backlog, the 52-week wait target, and the 18-week legal standard, with implementation by Spring 2024. They also announced an additional £3.3 billion for the NHS.

HM Treasury

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8 Accepted

This Committee first looked at post-pandemic backlogs in December 2021, publishing our report in March...

Recommendation

This Committee first looked at post-pandemic backlogs in December 2021, publishing our report in March 2022. We noted that officials appeared to be planning on the basis of optimistic future scenarios and also that there was general over-optimism from officials … Read more

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.

HM Treasury

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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 … Read more

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.

HM Treasury

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19 Accepted

We asked NHSE about its programme management of the recovery and its strategic approach to...

Recommendation

We asked NHSE about its programme management of the recovery and its strategic approach to tackling variation in performance between NHS areas. The National Audit Office found that, whilst recovery funding was allocated in September 2021 and the recovery plan … Read more

Government Response Summary

The government agrees with the recommendation and will assess all providers based on their confidence in delivering against targets, with providers at highest risk receiving additional national support and oversight; implementation by July 2023.

HM Treasury

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