GP targets to be removed

Released 22/06/2010

Health Secretary announces revision of NHS Operating Framework

The NHS is to begin to make immediate efficiency savings by tackling escalating management costs and removal of targets in primary care.

A revision to the 2010/11 NHS Operating Framework sets out changes to key priorities for the NHS including plans to reverse the rise in management costs seen in the last year.

Health Secretary Andrew Lansley said: "NHS spending will increase, but so too will the demand on NHS services. In order to meet this demand, the NHS needs to make substantial savings and that is why I want to see immediate action this year to reduce management costs so that the savings made can be reinvested in NHS care for patients.

"Management costs in Primary Care Trusts and Strategic Health Authorities have increased by over £1bn since 2002/03, with over £220m of the increase taking place during 2009/10.

"Management costs now stand at £1.85bn and it's our intention that during 2010/11 we will remove all the management costs that have been additionally incurred during 2009/10, to get back to the level of 2008/09. Then in subsequent years, we will go beyond that, with a further £350m reduction in 2011/12."

The overall reduction in management costs by 2013/14 will be £850m, which is a 46 per cent reduction on the 2009/10 management costs.

The revised Operating Framework also sets out for the first time changes to the use of targets in the NHS. These include:

removal of targets around access to primary care, with the 48 hour access target removed
removal of top-down performance management of the 18 weeks referral to treatment target
reduction of the four hour accident and emergency target threshold from 98 per cent to 95 per cent.

Lansley added: 'I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes. Doctors will be free to focus on the outcomes that matter - providing quality patient care.

"But I want to be clear - while the NHS will no longer be accountable to ministers or the Department for its performance in these areas, it will be very much accountable to the patients and public it serves. Patients will still be entitled to rights under the NHS Constitution and the quality of their experiences and outcomes are what will drive improvements in the future.

"We expect providers to continue to make improvements, for example on referral to treatment times, and to provide this information to patients themselves, driving choice and competition in the NHS."

Commenting on the intention to remove the 48 hour access target, Dr Laurence Buckman, chairman of the BMA's GPs Committee, said: "Patients should have good access to GPs. However, while this target may have been intended to improve access it has in fact had adverse consequences.

"At the moment practices need to have enough appointments available on the day or the following day to meet the target, so those who want to book in advance find there are fewer appointments available. We would therefore welcome the scrapping of this target as it will give GPs greater flexibility to organise their appointment booking system in a way that best suits their local patient population."

Commenting on the relaxation of the 18 week referral to treatment target; and the relaxation of the 4 hour A&E target, Dr Keith Brent, deputy chairman of the BMA's Consultants Committee, said: "Waiting time targets have improved the NHS in many respects, but they have also resulted in pressure on staff to make inappropriate decisions. Patients must always be treated as individuals and we welcome this commitment to allow doctors the freedom to do what is clinically appropriate."

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