Elective recovery plan welcome but focus on hospital care target risks undermining long-term reforms

Responding to the forthcoming elective recovery plan, Sarah Woolnough, Chief Executive of the King’s Fund said:

‘In recent weeks the government has pledged that, by the end of this parliament, 92% of patients waiting for planned hospital care will be seen within 18 weeks. It is an ambitious goal as the latest data shows that the current waiting list stood at 7.5 million in October, and only 58.9% of patients were seen within the 18-week target. 

‘This plan sets out the welcome approach the NHS will take to deliver this stretching ambition – including by bolstering patient choice, delivering care in the right settings and focusing on reducing the unequal experiences people face waiting for hospital care. Similar measures have been shown to work in the past, however, much of the deliverability of the plan hinges on government decisions at future spending reviews, and it is likely that there will need to be difficult decisions about where the health service focuses its finite resources. 

‘In particular, it is good to see that boosting diagnostic capacity through community diagnostic centres is a core part of this plan, given that the latest figures show the backlog for tests and scans in England stood at over 1.6 million appointments. It is important that centres are outside of the existing NHS estate, such as in shopping centres, to improve access for underserved and more-deprived communities. 

‘However, while significantly reducing long waits for planned hospital care is a worthy goal, the 18-week referral-to-treatment target should not be taken as the sole measure of how the NHS is faring. Equally important to people are how long they are waiting for a GP appointment or an ambulance, for mental health care and for other services. 

‘To seriously transform the NHS and the care patients receive, ministers should conduct a more wide-ranging and fundamental review of health service targets so that they incentivise the improvements to services that patients need. If the NHS becomes too focused on achieving one hospital care target, it risks undermining more fundamental, long-term reforms designed to prevent illness, move more care out of hospitals, and create an NHS “fit for the future”.’ 

Notes to editors

• The King’s Fund published a new chart showing the scale of ambition to meet the 18-week target. If you would like to recreate this graph citing The King’s Fund, please contact the media team. 2024 Health Policy Year In 12 Charts | The King's Fund

• The King’s Fund published a report which explored strategies to reduce waiting times in the early 2000s: Strategies to reduce waiting times for elective care

• In 2020, after the first wave of the Covid-19 pandemic, NHS England asked NHS trusts and systems to take an inclusive approach to tackling waiting lists by disaggregating waiting times by ethnicity and deprivation to identify inequalities and to take action in response. The King’s Fund undertook qualitative case studies about the implementation of this policy: Tackling health inequalities on NHS waiting lists

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The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.