Patients will be given ‘greater choice and control’ over their treatment and GPs will be funded to work with hospital doctors to get specialist advice before making referrals, under new government plans to tackle hospital wait times.
But the Royal College of Nursing (RCN) has warned the ‘missing link’ in the government’s plans is the nursing workforce – an issue not mentioned in the new blueprint.
The government has today published it’s NHS Elective Reform Plan which sets out a ‘whole-system approach’ to hitting the 18-week referral to treatment target by 2029.
Unveiling the plan in a press conference this morning, Prime Minister Keir Starmer said incoming changes would see an increase in community diagnostic centres and patients with long-term conditions given technology to ‘monitor themselves at home’.
He also pointed to new funding given to GPs to consult with hospital specialists, something he said would ‘avoid an extra 800,000 unnecessary referrals and appointments’ a year.
Further details in the plan explain that GPs will receive £20 per Advice and Guidance (A&G) request – a service that allows primary care clinicians to seek advice from secondary care specialist clinicians before or instead of making a referral.
‘We expect this to increase uptake, with more patients benefitting from their GP accessing rapid specialist advice, so they receive the care they need in primary and community care settings, as opposed to being added to the elective waiting list,’ the plan said.
‘This expansion will deliver up to four million advice requests from GPs in 2025/26 (up from 2.4 million in 2023/24), which we expect could increase diversions from elective care from 1.2 million in 2023/24 to 2 million in 2025/26.’
The plan also sets out that patients will be given ‘greater choice and control’ over their treatment through the NHS App.
‘This includes making sure patients can get better access to information via the app, such as the details of their appointments, results and waiting times, and use it to book appointments in the location of their choice, with information about waiting times and patient satisfaction,’ the government said.
In addition, the plan also suggests there will be action taken to NHS e-RS – the digital platform used by GPs and practice staff to book outpatient appointments at hospitals and clinics.
Changes will include standardising referral information on the platform and including data to better prioritise children and young people’s care and reducing reliance on analogue referrals.
Sir Keir added: ‘Across the NHS, we will put patients in control of their care, and to meet that demand, we will also move care closer to their lives, shift treatment away from hospitals and centres and deliver more care at their GPs, in their community and in their homes.’
The Prime Minister added that efforts will be focused on cutting waiting times and fixing inefficient care that the health system ‘can’t afford’.
The plan acknowledges how elective care usually takes place via a specialist hospital outpatient appointment and says reforming elective care ‘cannot be achieved’ by simply shifting care from other parts of the health and care system.
‘More integrated working between primary and secondary care, community, diagnostics, tertiary centres and the independent sector is essential,’ the plan added.
Responding to the plan, RCN general secretary and chief executive Professor Nicola Ranger, said: ‘Patients are waiting too long for treatment and modernisation in the NHS is needed. But the missing link in all of this is the nursing workforce.’
While pointing to the tens of thousands of vacancies across the profession, she added: ‘Nursing staff support patients right to choose, but they know all too well that choosing between two understaffed services is a false choice.
‘Nursing delivers the majority of care and is central to the government’s mission. We desperately need new investment in our workforce otherwise all attempts to improve patient care and modernise the NHS will never get off the ground.’
The elective plan also shares the government’s commitment to ‘tackle health inequalities’ by working across primary and community care to ensure vulnerable and disadvantaged patients are well served, especially those with multiple long-term conditions.
It also highlights how integrated working across primary, community and secondary care will be used to target specific conditions outside of traditional hospital settings.
For example, in gastroenterology, an integrated pathway will be developed to treat common gastroenterology conditions, including efforts to reduce consultant-led outpatient appointments in this area.
Commenting on the announcement NHS chief executive Amanda Pritchard said many people are waiting ‘unacceptably long’ for care.
‘By making it easier for people to get timely access to the tests they need alongside direct referrals and same day checks and consultations – this plan will help thousands more people to get a faster diagnosis and quicker treatment or the all clear, so people can get back to living their lives as soon as possible, with peace of mind that they won’t need further treatment,’ she explained.
The reforms also include a new agreement between the NHS and independent sector, offering patient’s a greater choice of providers in a range of specialist treatment areas, including gynaecology and orthopaedics.
Last week, the government announced it will launch an independent commission to ‘rebuild’ adult social care but cautioned that long-term social care reform is unlikely before 2028.
In the same month, Nursing in Practice reported that the government is developing a new long-term workforce plan that is due to be published this summer and has a greater focus on public heath.
The Labour party’s pledge to ‘shift resources’ to primary care and create a ‘National Care Service’ was a core 2024 manifesto promise and is a key part of its 10 Year Health Plan.
