Hunt orders NHS England bosses to stick to waiting time limits

The Health Secretary has rejected service chiefs’ public warning that meeting targets is impossible without current funding, and has ordered them to stick to waiting time limits.

NHS England told ministers it would not be able to guarantee waiting times and would delay patients new drugs next year because of lack of funding, following the Budget.

The Health Secretary has rejected these proposals and signalled the start of months of difficult negotiations over what care the NHS can and cannot afford to provide in 2018-19.

NHS England used its board meeting to warn that it had to make ‘difficult choices’ next year that would involve limiting what it could provide for patients. It blamed the Chancellor for creating what the Patients Association said was an ‘extraordinary’ situation by giving it only £1.6 billion extra funding for 2018-19 in his budget last year, less than half of the £4 billion Simon Stevens called for.

NHS England made plans to stop prescribing cough mixture, cold treatments, eye drops and laxatives, which it wants patients to buy over the counter instead, as well as fish oil, herbal remedies and homeopathy, as part of a plan to save up to £190 million from its £9.2 billion bill for prescribed medications.

It also said it may refuse to act on new guidance from the National Institute for Health and Clinical Excellence (NICE) if it believed it did not have the money or staff to implement them. That could lead to England’s 209 NHS clinical commissioning groups refusing to pay for new drugs that NICE has deemed value for money for the NHS or declining to change practice as a result of guidelines that NICE issues to promote better care.

NHS England dismissed the idea that the service could be expected to provide even more care at a time when its annual budget increases of one to two per cent were far smaller than rises in patient demand, running at up to seven per cent a year.

Patient groups and medical organised were alarmed by NHS England’s threats.

Rachel Power, chief executive of the Patients Association, said: “It made clear how patients will lose out as a result of political decisions about the funding of health and social care. There will be longer waits for elective surgery, and therefore more pain and worse outcomes for many. NHS England has also said it is unable to implement best practice as advised by Nice on a routine basis – an extraordinary state of affairs. We have now reached a point where the NHS constitution will be routinely breached and NHS services are being withdrawn.”

Chaand Nagpaul, chair of the British Medical Association, said it was ‘deeply worrying that the body with responsibility for running the NHS is warning of the service’s inability to meet national standards of care. Unfortunately, it is patients who are unfairly suffering the consequences of a clearly underfunded service. Doctors can’t continuously plug gaps by penny pinching and poaching from elsewhere in an overstretched service’.

Derek Alderson, president of the Royal College of Surgeons, said: “Rationing and delaying surgical treatment are false economies. For example, current commissioning group policies designed to delay surgical access for obese patients and smokers only defers treatment and potentially adds costs through increased use of painkillers, physiotherapy and welfare support for out-of-work patients.”