Testing out new targets is a big improvement on the usual directive approach - Nigel Edwards

Our response to NHS England’s new review of NHS access standards for A&E, mental health, cancer and referral to treatment.

Press release

Published: 11/03/2019

Reacting to NHS England’s new review of NHS access standards, Nuffield Trust chief executive Nigel Edwards said:

“NHS targets never work as expected in the real world, so the idea of testing out new proposals and carefully monitoring the effect on patients is a big improvement on the usual directive approach. I agree that the A&E target is overdue a check-up: it has started rewarding the wrong behaviours, like moving patients just to stop the clock. The new target to treat patients with a mental health crisis within an hour at A&E sends exactly the right message about the urgency called for in those situations.

“Given the history of targets having unintended consequences we will need to watch closely as these trials go ahead, looking at the actual effect on people’s health as well as access to care. There is a risk that getting rid of the 18 week limit on waits for planned procedures could mean the proportion of people going without care for an unacceptably long time drifts upwards. And we need to be hard-headed about how much difference fine tuning targets will make – the root causes of poor performance lie in a lack of staff and capacity, which we have barely started solving.”