New Health Secretary Andrew Lansley today set out changes to the NHS Operating Framework. There are some encouraging items on abolishing the culture of targets: Guarantees of a GP appointment within 48 hours will be removed; there will be no more top-down performance management of the 18 weeks referral to treatment target; and the four-hour accident and emergency target threshold will be reduced from 98 per cent to 95 per cent. These are good measures as clinicians will now prioritise who should be treated first - as the Deputy Chairman of the British Medical Association Consultants Committee said, targets can lead clinicians to make "decisions that are inappropriate".
Also encouraging is the amount to be saved in the costs of management - £850 million (46 percent) in the next few years. As we said the other day though, this needs to be combined with structural reform in the long term. It's no good cutting these costs now and then putting saved money back into the same system. Removing bureaucracy should go alongside giving Trusts more independence, with increased accountability and choice for consumers.
As a new report from 2020 Health out today says, there are savings to be had in the NHS budget (they outline £12 billion in the paper). The mistake would be reinvesting the money into an organisation so heavily controlled from Whitehall. So today's reforms are a good start but there's clearly a long, long way to go.