Prime Minister Sir Keir Starmer has unveiled the government’s Elective Reform Plan, which aims to end NHS backlogs by offering up to half a million more appointments each year thanks to greater access to Community Diagnostic Centres and new or expanded surgical hubs.
Millions of patients will be able to access more appointments closer to home and get the treatment they need faster under a new plan to tackle hospital backlogs set out by the prime minister on Monday 6 January. Greater patient choice over follow-up care will be part of a drive to open-up one million appointments, alongside better use of tech and other action to save another million missed appointments.
The Elective Reform Plan, published by NHS England, sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament. This includes expanded use of Community Diagnostic Centres (CDCs) so that many more people will be able to access tests and checks while going about their daily lives, and the NHS will also increase the number of surgical hubs, which help protect planned care from the impact of seasonal and other pressures. Tackling current waiting lists so that the NHS once again meets the 18 week standard for planned treatment is a key milestone in the government’s Plan for Change.
The plan will drive forward progress on the government’s first steps commitment to deliver two million extra appointments in its first year, equivalent to 40,000 every week. The reforms will put patients first, harness technology to support staff and help the NHS to do things more efficiently.
Up to half a million more appointments a year are expected to be created in total by opening CDCs for longer and bringing 17 new and expanded surgical hubs online. Opening CDCs for 12 hours a day, seven days a week wherever possible will mean people can access a broader range of more appointments closer to home in their neighbourhoods. This will make sure they are treated more quickly and more conveniently, rather than having to rely on hospitals.
The plans also involve increasing the availability of same-day tests and consultations so that patients don’t have to wait for weeks in between different stages of care. They will also expand the range of tests available at CDCs so people get better access to treatment, and enabling GPs to direct patients straight to diagnostic testing so that they receive their tests quicker, before having to see a specialist – in turn saving them time and travel.
Alongside the extended hours for CDCs, 14 new surgical hubs will be created within existing hospitals by June and three others expanded - with more expected in coming years supported by the £1.5bn capital investment confirmed at the Autumn budget. These will bring together the necessary expertise, best practice and tech under one roof to focus on delivering the most common, less complex procedures. The new hubs will be ring-fenced from winter pressures and will cut waiting lists for standard surgeries, in turn freeing up beds in acute wards needed for more complex cases.
Under the plan, 65% of patients will be treated within 18 weeks by the end of next year. Based on the size of the current waiting list, that would mean a fall of more than 450,000 people waiting more than 18 weeks for treatment.
Health and Social Care Secretary Wes Streeting said: “We inherited record long waiting lists, impacting patients’ lives and their livelihoods. Only the combination of investment and radical reform can turn this around, as we’re setting out today. Our Plan for Change set an ambitious target to cut maximum wait times from 18 months to 18 weeks, and we will achieve it by bringing care closer to home and give patients more choice over their treatment. The NHS should work around patients’ lives, not the other way around. By opening community diagnostic centres on high streets 12 hours a day, seven days a week, patients will now be able to arrange their tests and scans for when they go to do their weekend shopping, rather than being forced to take time out of work.”
Reform will also tackle deep seated structural issues which have held back improvements to date by bringing funding mechanisms, performance oversight and delivery standards together with incentives for positive change. This will ensure the system is set up in a way that rewards and actively drives improvements. Trusts who make the fastest improvements in cutting waiting times will be rewarded with additional funding for capital projects tailored to local needs. This could include investment in cutting edge AI diagnostic equipment or hospital ward maintenance.
There will also be greater transparency on performance and support in place for providers facing the greatest challenges, and new support for clinical and operational leaders on how to deliver more effective elective pathways.
The plan will also provide greater funding certainty, to help commissioners deliver their operational planning with more stability over their finances.