NHS bosses have told Britain’s political parties not to impose new targets on the beleaguered health service in their efforts to win the next general election.
The Conservatives and opposition parties should resist foisting new performance metrics on the NHS when it could not meet the hundreds under which it already operates, they said.
The plea has been made by the NHS Confederation, which represents hospitals and providers of ambulance, mental health, community care and GP services in England.
In a pointed intervention in the debate about how to tackle the growing crisis in the NHS, and before manifestos are drawn up for the next election, due by January 2025, the confederation warned that introducing extra targets would risk damaging already diminishing public trust in the service.
Given the NHS’s staff shortages, huge backlog of care and financial problems, “leaders believe that the answer will not be found in politicians imposing oversimplified and unfunded targets that make convenient soundbites but have little bearing on reality,” the confederation said.
“These do nothing but demoralise frontline workers and raise public expectations at a time when satisfaction levels are at their lowest point despite everything NHS staff are doing.”
The NHS across the UK has become increasingly unable in recent years to meet key standards covering access to GPs, A&E care, cancer care and elective procedures in hospitals, and also to ensure ambulances reach patients within maximum waiting times after a 999 call. For example, hospital A&Es in England have not met the target of treating and then admitting, discharging or transferring 95% of patients within four hours since 2015.
The performance of different parts of the health service in England is already driven by an array of what experts estimate are several hundred targets, many of which specify how quickly patients should have an appointment, receive a diagnostic test or undergo treatment.
However, hospital bosses in particular want a ban on any new ones being created.
Matthew Taylor, the confederation’s chief executive, said: “Health leaders understand that the government and politicians may want to send a strong message about their expectations of the NHS. But the worst thing they could do now is commit local services to a raft of new targets when it is difficult enough meeting existing ones.
“This isn’t the NHS wanting to avoid accountability, but it’s about making sure we have a realistic set of performance measures.”
The service must be left to deal with “eye-watering waiting lists, huge staffing vacancies and a cost of living crisis which could see services struggling to stay afloat” rather than have to contend with the imposition of new measurements of its performance, he said.
The confederation was demanding a review of how useful the existing targets are, with some NHS chiefs privately favouring a “streamlining” of the total.
The health and social care secretary, Thérèse Coffey, was recently criticised by GPs for unveiling in her NHS plan a new “expectation” that patients should be able to see a family doctor within two weeks and that the sickest patients should receive an on-the-day appointment. The Royal College of GPs – whom Coffey had not consulted – said the new patient right would prove difficult to deliver, given the declining number of family doctors and their already large workloads.
The health secretary has had to delay bringing in the new policy until April and it will be the subject of potentially fraught negotiations about the new GP contract covering 2023-24.
Coffey has also become embroiled in a second row about targets in her first month in the job, involving the four-hour A&E target. NHS England and organisations representing both hospital bosses and A&E doctors were expecting to see it replaced with a new basket of metrics of emergency departments’ performance, but the minister ruled out abolition.
The Department of Health and Social Care defended targets as a way of tackling the care backlog, and rejected the confederation’s call not to introduce extra performance metrics.
A spokesperson said: “The health and social care secretary is focused on putting patients first and will do this by focusing on her ABCD priorities – including easing pressure on ambulances, clearing the Covid backlogs, supporting the care sector to ensure people can leave hospital and improving access to doctors and dentists.
“It is right that the NHS delivers for patients and we have set ambitious targets to help the NHS recover from the impact of Covid – backed by more than £8bn – which has already seen two-year waits virtually eliminated.”
Wes Streeting, the shadow health secretary, said Labour would retain existing targets but declined to rule out creating new ones.
He added: “Instead, we will train the doctors and nurses the NHS needs to treat patients on time again. Labour will undertake one of the biggest expansions of the NHS workforce in history, paid for by abolishing non-dom status.”
