Power to the patient as government sets out plans to cut waiting lists

A revolutionised NHS App is among a raft of proposals aimed at giving patients greater power over how and when they receive elective treatment, as the government sets out its roadmap to cutting waiting times as confirmed in the Plan for Change. 

Currently, fewer than a quarter of patients recall being offered a choice of hospital for their treatment. Patients have a legal right to choose their provider and the government wants to give them more control over their own care.

Under measures in the forthcoming Elective Reform Plan, patients will be offered a wider choice of providers and the process of booking treatments and appointments will be made as smooth, supportive and convenient as possible. 

Planned NHS App upgrades will enable patients requiring non-emergency elective treatment to:  

• View and manage appointments at a time and place that is convenient to them, reducing missed appointments, which are costly to the NHS – in 2023/24, there were 8 million missed appointments in elective care.
• Choose from a wide range of providers, including in the independent sector  
• Book diagnostic tests through the NHS App at convenient locations, such as a Community Diagnostic Centres (CDCs) in a local shopping centre 
• Receive test results quickly through the App before choosing the next step – whether a remote consultation or surgery – at a convenient time and location 

As a first step, by March 2025, patients at over 85% of acute trusts will be able to view appointment information via the NHS App.  

Patients will also be able to contact their treatment provider at their convenience, and receive clear information and regular updates, including on how long they are likely to wait for their appointment.  

Currently, most patients receive test results through a phone call from a clinician, or a letter with either the result or instructions to book an appointment to discuss them further. This can be a significant time after the diagnostics took place. Enabling patients to receive test results quickly through the App will help address these inefficiencies in the process.

The proposals are part of the elective reform plan, set to be announced this week, which sets out how the government and NHS will deliver on its Plan for Change to slash the waiting list and cut waiting times to 18 weeks by the end of this Parliament.   

The plan marks the start of a new era for the health service that will put patients in the driving seat and in control of their own care.  

Health and Social Care Secretary, Wes Streeting said:

“If the wealthy can choose where and when they are treated, then working class patients should be able to as well, and this government will give them that choice.

“Our plan will reform the NHS, so patients are fully informed every step of the way through their care, they are given proper choice to go to a different provider for a shorter wait, and put in control of their own healthcare.

“This government's reform agenda will take the NHS from a one size fits all, top down, ‘like it or lump it' service, to a modern service that puts patients in the driving seat and treats them on time – delivering on our Plan for Change to drive a decade of national renewal.

“By bringing our analogue NHS into the digital age, we will cut waiting times from 18 months to 18 weeks and give working class patients the same choice, control, and convenience as the wealthy receive.”

The NHS currently lags behind in digital communications, with just 8% of bookings after a referral being made via the NHS App or the Manage Your Referral website. The proposals will drive up this figure by making the NHS App and Manage Your Referral site the default route for patients to chooser their provider, or decide not to make that choice themselves.

Greater choice will be available so people can take control of their health, with strengthened communications to patients through the App, making them aware of the options available to them. 

More widely, the plan establishes minimum standards patients should expect - giving them more power over decision-making and what they can expect to be able to do: 

• Choose how they receive follow-ups for care, whether this be digitally or in-person.
• Receive a shortlist of providers to choose from, have the option to choose an appointment that suits them, and the receive information on how to change their appointment.
• Decide whether a follow-up appointment is necessary or whether it is more beneficial to continue recovering at home.
• Have the ability to contact their provider for any necessary follow-up, rather than being called back at intervals that don't suit their circumstances.
• Get clear communications that meet their needs throughout their time on the waiting list – including to check whether they still want to be on the list

NHS chief executive Amanda Pritchard said:

“NHS staff are providing record levels of elective care but with too many patients waiting, we know we need to reform further and faster so we can take our progress on the backlog to the next level.

“That is why as part of the Elective Reform Plan we will fully harness the potential of the NHS app, giving patients more information, choice and control over their care while freeing up the time of our staff so they can work more productively too.

“Using technology to revolutionise access to NHS care, alongside offering more availability of tests, check and scans closer to people's homes will help us tackle waiting times and put patients in the driving seat of elective care.”

Measures to improve two-way communication between patients and clinicians, as well as making better use of AI to predict missed appointments, could also save an additional one million missed appointments.

Missed appointments add significant delay to patients receiving care, increasing pressures on elective services and potentially other areas of the health service. Sending reminders has been shown to reduce missed appointments by up to 80 per cent, and Trusts report better results when communication is two-way with the patient.

Work is underway to pilot AI services that identify patients more likely to miss appointments and provide support, such as free transport to those most in need.  

And accessible and alternative language, as well as tailored communications will be made available, particularly in areas of highest inequalities, to ensure all patients have the information they need to take control of their care.

The plan puts the patient back at the heart, meaning they can receive care that best suits them and their individual needs, by empowering to take more control over when, where and how they will be treated.

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NOTES

For guidance only: On Monday 6 January, the Prime Minister will deliver remarks setting out how the government will deliver its Plan for Change milestone to cut NHS waiting times. The remarks and media Q&A will take place in the South East.