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NHS maximum waiting times and patient choice policies

Published Tuesday, October 16, 2018

House of Commons Library briefing on NHS maximum waiting time standards and patient choice.

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This briefing describes policies on NHS maximum waiting time standards and patient choice, principally in England, although a brief synopsis of waiting times standards across the UK is provided. The Library also publishes a statistical bulletin, NHS Key Statistics, which provides the latest figures for waiting times.

As set out in the NHS Constitution, patients have the right to a maximum 18 week waiting time from referral to consultant-led treatment. Patients also have the right to be seen by a cancer specialist within a maximum of two weeks from GP referral for urgent referrals where cancer is suspected. In September 2015, the Government pledged to introduce a new four week waiting time standard for cancer diagnosis by 2020.

The NHS Constitution also provides a series of pledges on maximum waiting times for services such as diagnostic tests, A & E, and treatment for diagnosed cancer.

Many of these expected standards are monitored as a percentage of patients. If the expected percentage of patients is not seen within the standard, the Government can impose financial sanctions if this is set out in a provider’s contract. However, although since April 2016 many local NHS teams have not met the standards for A&E and elective care, the Government has not imposed sanctions. Instead it has focussed on improving standards, particularly in A&E departments.

Since 2015, the Government has introduced a number of waiting time standards for talking therapies, treatment for psychosis and children and young people with an eating disorder. The Government is piloting a four-week target for access to specialist children’s mental health services in several areas in England.

The Government and NHS England are also working to improve patient choice within the NHS, which is a legal right as set out in the NHS Constitution.

Patients have a right to choose their provider and consultant-led team when they are referred for their first outpatient appointment with a service led by a consultant. These rights were for the first time extended to mental health services in April 2014. There are some exceptions to this right, including for people detained under the Mental Health Act 1983.

To further strengthen patient choice, a legal right to have a personal health budget was introduced for adults receiving NHS Continuing Healthcare and children and young people receiving Continuing Care in October 2014. The NHS Mandate 2014-15 also set an objective for the NHS to further roll out personal health budgets to anyone who could benefit, by April 2015.

In 2015, the Government made clear its intention to bring greater choice in palliative care. This included personal health budgets, but also introducing new digital solutions, new care coordinator roles, better training and more public campaigns to promote personalisation of end of life care.

In successive Mandates, the Government has expressed the desire to introduce more choice for maternity services, palliative care and people with long-term conditions by 2020. The Government has consulted on giving more groups the right to have a personal health budget (including those with learning disabilities and wheelchair users) but has not yet published its response to the feedback.

Commons Briefing papers CBP-7171

Authors: Elizabeth Parkin; Alexander Bellis; Carl Baker

Topics: Health services, Patient rights and complaints

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