NHS set to MISS key health service recovery targets

Britons will die younger and in poorer health because the NHS is failing to recover quickly enough from the pandemic, a damning report by MPs warns.

The service is unlikely to hit key recovery targets for routine operations and cancer care despite a significant injection of extra cash, the Public Accounts Committee reveals.

The cross-party group highlights poor workforce planning and says there are not enough staff and scanners to rapidly tackle record waiting lists of 7.2million people.

Its report notes the first year of NHS England’s three-year recovery programme is already ‘falling short of expectations’, with a detrimental impact of people’s quality of life.

NHS cancer data for December shows that just six in 10 started treatment within two months from an urgent GP cancer referral (red line), leaving 5381  (blue line) patients waiting more than 62 days for cancer care

This is because bosses made ‘over-optimistic’ assumptions, including that there would be low levels of Covid and minimal adverse effects from winter pressures, it adds.

The Committee has now expressed serious doubts that the wider NHS recovery plan will be achieved on time and describe waiting times for cancer treatment as ‘especially worrying’.

Committee chairwoman Dame Meg Hillier, a Labour MP, said: ‘Despite a significant cash injection meant to begin to help the recovery from the pandemic, the NHS is in full blown crisis and all the metrics are going in the wrong direction.

‘On the evidence we have received the NHS will not achieve the targets in its recovery plan, and that means health, longevity and quality of life indicators will continue to go backwards for the people of this country.

‘That is simply shameful, and totally unacceptable in a nation as wealthy as ours.’

Committee chairwoman Dame Meg Hillier, a Labour MP, said: ‘Despite a significant cash injection meant to begin to help the recovery from the pandemic, the NHS is in full blown crisis and all the metrics are going in the wrong direction’

The report says cancer waiting times are at their ‘worst recorded level’ and NHS England will not meet its first cancer recovery target.

Some 85 per cent of people who have been urgently referred by their GP and have cancer confirmed should start treatment within 62 days.

But in the first five months of 2022/23, only 62 per cent of patients met this target, with 11 per cent of patients being treated more than 104 days after an urgent referral – at least twice as long as they should be made to wait.

Delays reduce survival chances and can make treatment more expensive and less effective.

NHSE set a recovery target that the weekly count of patients waiting over 62 days would recover to the pre-pandemic level by March 2023.

And in July 2022 the Chief Executive of the NHS wrote to all NHS trusts stating that cancer care was a critical priority for the rest of the year.

However, in evidence to the Committee at the end of November, NHS England acknowledged that this first cancer recovery target would be missed.

The recovery plan also stated that activity levels would recover to pre-pandemic levels early in 2022/23.

But between April and August 2022, elective activity – non-emergency treatment – was at just 95 per cent of pre-pandemic levels.

It is ‘clear’ that the further aim of increasing activity to 129 per cent of pre-pandemic levels by 2024/25 is ‘unachievable’, the report adds.

MPs said that, for the recovery plan to succeed, the capacity of adult social care must improve so people can be discharged from hospital in a timely way.

In addition, there needs to be more clarity on how large the workforce needs to be and ‘how long it will take to reach these levels through sufficient domestic training’.

There are currently 133,000 vacancies within the health service and NHS England has committed to publishing an NHS workforce plan by April 2023.

The Department of Health has allocated £14billion to NHS England from 2022/23 to 2024/25 specifically to recover elective and cancer care.

The Autumn Statement 2022 committed an additional £3.3billion in 2023/24 and 2024/25 to the NHS budget as a whole, and health service bosses told the Committee this would be sufficient for the NHS to deliver its key priorities.

However, NHS England has opted not to produce a detailed costed version of its recovery plan to show how it expects all of the £14billion to be spent.

Sir Julian Hartley, chief executive of NHS Providers, which represents NHS trusts, said: ‘Trust leaders are working extremely hard to tackle the backlogs and have made remarkable progress towards eliminating 78-week waits by April given the mounting pressures they face. 

HM Treasury data shows the NHS annual budget. In 2020/21, the NHS was given £129.7billion of core funding for its usual services, which was topped up with an extra £18billion to help with the pressures from the pandemic. For 2021/22 the Treasury said the health service received £136.1billion pounds of core funding, as well as £3billion to help with the Covid recovery. The health service has been allocated £151.8billion for 2022/23 and £157.4billion for 2023/34. The Autumn Statement topped up these figures by £3.3billion each

The NHS spends around £150billion-a-year, of which just under 43 per cent is spent on staff wages. Graphic shows: A pie chart of Department of Health and Social Care revenue spending on the NHS (left) in 2019/20 and areas where expenditure is seen to have been wasted (right)

‘However, a very tough winter, the impact of industrial action and vast workforce shortages are just some of the challenges threatening to undermine these efforts.

‘The Government opening talks with all striking unions will be key to resolving pay disputes and averting more strikes.

‘The national workforce plan, which needs to be fully funded by the Government, should also go some way to address staff shortages and equip the NHS with the resources it needs.’

Sir James Mackey, national director of elective recovery at NHS England, said: ‘This release includes a number of factual errors and, sadly, fails to acknowledge the significant progress made by NHS staff on the Elective Recovery Plan despite record pressures seen across the health and care system.’

A Department of Health and Social Care spokeswoman said the NHS ‘has already made strong progress in tackling the Covid backlogs’, adding: ‘We are working to reduce the 62-day cancer backlog – which has fallen 9 per cent since peaking in 2020 – but we know there is more to do.

‘We have opened 92 community diagnostic centres that have delivered over three million tests, scans and checks to detect cancer and other conditions as early as possible, with 19 more opening this year.’