Keir Starmer is unlikely to fulfil his pledge to restore the maximum 18-week wait for planned hospital care before the next election, a leading thinktank has said.
The prime minister has made bringing back the 18-week access standard in England, by ensuring that 92% of patients are seen within that time, one of the six “milestones” he has promised to achieve by 2029.
However, he is “more likely than not” to fail to realise his ambition, because the NHS will not be able to meet the ever-rising demand for care, the Institute for Fiscal Studies says.
The health service has not met the longstanding 92% referral to treatment target since September 2015 and there is widespread scepticism among health experts that it can be restored by 2029.
The latest figures show that 6.25 million people were waiting to receive 7.43 million elective – or planned – treatments or appointments in hospital at the end of January, which underlined the huge scale of the backlog of NHS care that needs to be tackled.
Long waits for surgery, cancer care and diagnostics, which became routine in the 2010s as the NHS’s performance plummeted, have become a key concern for the public. In December hospitals treated only 59% of those on the referral-to-treatment waiting list within 18 weeks, far short of the 92% target.
“There is widespread agreement that achieving the 18-week target within this parliament – reversing nearly a decade of worsening performance in five years – will be challenging,” said Olly Harvey-Rich, a research economist at the IFS and co-author of the report.
It is “highly unlikely” that the NHS can deliver Starmer’s pledge simply by increasing the number of patients it treats, the IFS analysis concludes. It would also need to reduce demand and prioritise those who have waited the longest in order to do so, it believes.
The service would need to increase the amount of planned care it provides by 4.9% every year until 2029 in order to hit the 92% target. That is far higher than the 2.4% rise seen during 2016-2019, although that figure rose to 3.8% last year. Annual rises of 3.5% are more likely, the thinktank says.
The Department of Health and Social Care acknowledged that restoring 92% performance was “challenging” but said it was “pulling every lever” to make it happen.
It is already using measures recommended by the IFS to curb the backlog, such as community diagnostic centres and private hospitals treating NHS patients, a DHSC spokesperson said.
“Through our plan for change we have already delivered the 2m more appointments we promised – seven months early – and taken 195,000 off the waiting lists so far,” they added.
The chances of the NHS meeting the 18-week target by the end of this parliament is “vanishingly small”, said Sarah Scobie, the Nuffield Trust thinktank’s deputy director of research.
“The dilemma ahead is this: increasing hospital activity – such as through weekend working or more overtime – costs money. So this will be incredibly difficult during such financially-constrained times.
Ministers are facing “a long, hard road” to get all 11 key NHS waiting times – including four–hour A&E care and cancer treatment within 31 or 62 days – back on track, she added.
Meanwhile, the NHS should start using high street opticians to help speed up treatment for people waiting for eye care, the patient watchdog says.
The move would help cut the number of people waiting for treatment related to their vision, 70% of whom report a decline in their sight during their delay, Healthwatch England says.
