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NHS operations: Waiting times to rise in 'trade-off', boss says

NHS operations: Waiting times to rise in 'trade-off', boss says

NHS patients in England face longer waits for hospital operations such as knee and hip replacements in a "trade-off" for improved care in other areas, NHS England boss Simon Stevens says.

He said he could no longer guarantee treatment in the 18-week target time. And he said GPs would be asked to cut back on the numbers of patients they referred to hospital with other options such as physio encouraged instead. But he said in return there would be quicker cancer diagnosis and A&E care.

Mr Stevens was speaking as he unveiled a progress report on his five-year strategy for the health service that was launched in 2014. He said demand was rising at a quicker rate than expected when he originally set out his plans and so compromises had to be made.

"There is a trade-off here - we do expect there will be some marginal lengthening of waiting lists, but this will still represent a strong, quick experience compared to 10 years ago, let alone 20." Non-emergency treatments include everything from minor surgery and cataract operations to knee and hip replacements.

Patients are meant to be seen within 18 weeks. There are currently over 360,000 patients on the waiting list who have waited longer than that, which is one in 10 of the total, a proportion that has almost doubled in four years.

Mr Stevens said he expected that to get worse over the next couple of years. But he pointed out it needed to be seen in context of the situation a decade ago when nearly half of patients were waiting longer than 18 weeks.

GPs are being asked to look at how many patients they are referring to hospital - and whether other options, such as physiotherapy, would be more appropriate than operations. Mr Stevens said this process could lead to hundreds of thousands fewer patients being referred to hospital.

In return, NHS England made a series of pledges about how they would improve performance in certain areas. As Health Secretary Jeremy Hunt has already indicated, the four-hour A&E target has been re-committed to. Hospitals have been asked to start hitting the 95% threshold again by March 2018. Current performance stands at just over 85%.

To help, each hospital is being asked to introduce GP triaging - whereby doctors are placed on the front door to advise patients with minor illnesses and injuries of other places they can get help.

Another area that will be prioritised will be cancer care. A strategy was launched in 2015 setting out a vision for "world class" services by 2020.

This latest report sets out how that is beginning to happen, with an upgrade of radiotherapy equipment and the introduction of 10 new rapid diagnostic centres by next March.

These steps, NHS England said, will help achieve the ambition of ensuring cancer diagnoses are made within four weeks by 2020, and lead to the 62-day target for cancer treatment to once again be hit - it has been missed for much of the past 18 months.

Dr Mark Porter, of the British Medical Association, said: "The NHS is at breaking point from a combination of increasing demand and inadequate resources. Achieving one delivery promise only by missing another is a textbook example of rationing access to care. It should not be happening in today's NHS."

Source: BBC

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