NHS says expect longer patient waiting times after Philip Hammond's budget denies crucial funds

Patients will have to wait longer for treatment because the additional funding awarded to the NHS in last week’s budget won’t cover health service priorities and waiting list reductions, health chiefs have said.

In a meeting today, NHS England’s board set out the principles for which services will be prioritised in the wake of the budget settlement for 2018/19.

The board said that the NHS should do “all it can” to prevent patients waiting longer than the recommended 18 weeks for non-urgent procedures, including joint operations, cataract surgeries, and fertility treatments.

Having not received the £4bn they asked for, these waiting time targets “will not be fully funded and met next year”, they said.

Prior to the budget, NHS England chief executive Simon Stevens made the unprecedented step of asking for the £350m a week pledged to the NHS by Brexit campaigners.

Health policy groups had said that a minimum of £4bn extra was needed next year to keep services running, but this was publicly refused by Chancellor Philip Hammond.

The eventual settlement was £1.6bn, with £335m made available for this winter and £900m in 2019/20.

The Autumn Budget said this funding “should enable the NHS to meet the A&E four-hour target next year, make inroads into waiting lists and improve performance against waiting time targets”.

But NHS England said “the difficult debate” about what can be delivered could no longer be avoided.

Its board set out key principles for funding services next year, though the details are likely to be part of upcoming negotiations with the Department of Health.

Priorities include upholding commitments to funding improvements in primary care, cancer and mental health services.

This comes after mental health leaders told The Independent earlier this week that any cuts would be a betrayal of the already underfunded services.

It also sets out that demand for urgent and emergency care services is expected to keep growing.

“Realistic plans” will therefore be needed to ensure sufficient funds are available for hospital and ambulance services to meet this, the board said.

With funding in these areas non-negotiable, NHS England said it will have to be “realistic about what can be expected from the remaining funds”.

Likely targets include savings from merging NHS organisations and local clinical commissioning groups.

It will also mean evidence based recommendations for treatments or policies from the National Institute of Health and Care Excellence (NICE) will only be implemented if “they are accompanied by a clear and agreed affordability and workforce assessment”.

But, most significantly, it will mean again abandoning waiting time targets for non-urgent care.

“There will be longer waits for elective surgery, and therefore more pain and worse outcomes for many,” Rachel Power, chief executive of the Patients Association, said.

She added that it was “an extraordinary state of affairs” that best practice guidance from NICE might not be implemented because of cost pressures.

Local NHS chiefs said they were already considering mandatory, three month minimum waits for these procedures to free-up capacity for urgent care.

The Royal College of Surgeons said restrictions on elective procedures were a false economy as some patients would deteriorate further.

RCS president Professor Derek Alderson said: “We accept that difficult decisions will need to be made but we believe more of the money released by the Government should be targeted at waiting times in the NHS before they deteriorate further.”

Jonathan Ashworth, Labour’s Shadow Health Secretary, said there were “serious legal questions” about the NHS “effectively abandoning” its waiting times targets.

“This will mean more and more patients waiting longer and longer in pain, discomfort and distress for elective operations. This is the real debilitating impact on patients’ quality of life of Tory austerity.

“As a matter of urgency Jeremy Hunt must now tell us whether he intends to amend the law and the NHS Constitution through legislation and publicly accept his Government’s funding squeeze is jeopardising legally guaranteed standards of patient care.”

The Liberal Democrat MP and former Health Minister Norman Lamb said that this should have been addressed with a new levy for the NHS which is backed by the majority of the public.

“The public very clearly wants to see more investment in the NHS as a national priority.

“We need to be honest with the British people that securing the best possible standards of care will mean all chipping in a little.”

A Department of Health spokesperson said: “We are supporting the NHS with an extra £2.8bn by 2019/20 to make progress on A&E and waiting time performance, including £335m this year to help with winter pressures.

“We expect NHS England will use that money to make sure every patient gets the treatment they require in a timely way.”