Since April 2011, The King’s Fund has published a quarterly monitoring report (QMR) to track, analyse and comment on the issues the health and care system is facing. This is the 28th QMR, which takes stock of what has happened over the past few months with NHS financial and operational performance in England.
Some of the key ambitions the national bodies set at the start of last year were:
- all clinical commissioning groups (CCGs) to financially balance with zero deficits, and the provider trust deficit to be contained to £519 million
- the majority of providers to meet the ‘95 per cent of patients treated within four hours’ accident and emergency (A&E) standard by March 2019, with national performance returning to 95 per cent ‘over the course of 2019’
- a reduction in the proportion of beds occupied by patients with delayed discharges to 3.5 per cent
- providers to maintain or reduce the number of patients on planned care (referral-to-treatment) waiting lists in March 2019, compared to March 2018; and to halve the number of patients waiting more than a year for care
Findings included the fact that some of these commitments were met – for example, the number of patients waiting more than a year for planned care was more than halved from 2,756 people in March 2018 to just over 1,000 people by March 2019.
But while this accomplishment reflects both progress and the hard work of staff, this is still 1,000 people too many – especially when the NHS has been asked to have zero tolerance of such long waits. The NHS was also far less successful in meeting its other main planned care target: rather than holding steady, the overall size of the waiting list rose by 5 per cent to well over 4 million people.
According to the Kings Fund, there is a long history of NHS planning guidance documents setting ‘ambitious but challenging targets’. There is an equally long history that suggests these targets are often both unrealistic and undeliverable. Setting targets that cannot be achieved is not helpful to anyone – and it must be hoped this realisation is reflected in the next set of planning guidance documents that are currently being written.