PM sets out plan to end waiting list backlogs through millions more appointments

Millions of patients will be able to access more appointments closer to home and get the treatment they need faster under a new plan to tackle hospital backlogs set out by the PM today [Monday 6th January].

Tackling the 7.5million strong waiting list inherited by the government so that the NHS once again meets the 18 week standard for planned treatment is a key milestone in the government's Plan for Change. Restoring this standard will mean millions of patients no longer have to have their lives put on hold.  

Currently, too many patients face long waits for appointments or surgeries and may be referred to hospitals they don't choose at inconvenient times, while appointments and staff time are being lost to inefficiencies or inconsistencies in care. 

The Elective Reform Plan, published today [Monday 6th January] by NHS England, sets out a whole system approach to hitting the 18-week referral to treatment target by the end of this Parliament. This includes expanded use of Community Diagnostic Centres so that many more people will be able to access tests and checks while going about their daily lives, and the NHS will also increase the number of surgical hubs, which help protect planned care from the impact of seasonal and other pressures.

The plan will drive forward progress on the government's first steps commitment to deliver 2 million extra appointments in its first year, equivalent to 40,000 every week. The reforms will put patients first, harness technology to support staff and help the NHS to do things more efficiently. 

Prime Minister Keir Starmer said: 

This Government promised change and that is what I am fighting every day to deliver.

NHS backlogs have ballooned in recent years, leaving millions of patients languishing on waiting lists, often in pain or fear. Lives on hold. Potential unfulfilled.

This elective reform plan will deliver on our promise to end the backlogs. Millions more appointments. Greater choice and convenience for patients. Staff once again able to give the standard of care they desperately want to.

This is a key plank of our Plan for Change, which will drive growth that puts more money in people's pockets, secures our borders and makes the NHS fit for the future so what working people live longer, healthier, more prosperous lives.

Up to half a million more appointments a year are expected to be created in total by opening Community Diagnostic Centres (CDCs) for longer and bringing 17 new and expanded surgical hubs online. Opening Community Diagnostic Centres (CDCs) 12 hours a day, seven days a week wherever possible will mean people can access a broader range of more appointments closer to home in their neighbourhoods. This will make sure they are treated more quickly and more conveniently, rather than having to rely on hospitals.

The plans also involve increasing the availability of same-day tests and consultations so that patients don't have to wait for weeks in between different stages of care. They will also expand the range of tests available at CDCs so people get better access to treatment, and enabling GPs to direct patients straight to diagnostic testing so that they receive their tests quicker, before having to see a specialist – in turn saving them time and travel.

Alongside the extended hours for CDCs, 14 new surgical hubs will be created within existing hospitals by June and three others expanded - with more expected in coming years supported by the £1.5bn capital investment confirmed at the Autumn budget. These will bring together the necessary expertise, best practice and tech under one roof to focus on delivering the most common, less complex procedures. The new hubs will be ring-fenced from winter pressures and will cut waiting lists for standard surgeries, in turn freeing up beds in acute wards needed for more complex cases.

Under the plan, 65% of patients will be treated within 18 weeks by the end of next year. Based on the size of the current waiting list, that would mean a fall of more than 450k people waiting more than 18 weeks for treatment.

Health and Social Care Secretary Wes Streeting said:

We inherited record long waiting lists, impacting patients' lives and their livelihoods. Only the combination of investment and radical reform can turn this around, as we're setting out today.

Our Plan for Change set an ambitious target to cut maximum wait times from 18 months to 18 weeks, and we will achieve it by bringing care closer to home and give patients more choice over their treatment.

The NHS should work around patients' lives, not the other way around. By opening community diagnostic centres on high streets 12 hours a day, seven days a week, patients will now be able to arrange their tests and scans for when they go to do their weekend shopping, rather than being forced to take time out of work.

The reforms we're launching today will free up millions of appointments, so the NHS can be there for us when we need it once again.

NHS chief executive, Amanda Pritchard, said: 

NHS staff have worked tirelessly to bring down the longest waits, treating record numbers of elective patients last year, but with one in nine people currently on a waiting list it is right that we now go further and faster.

This ambitious blueprint will build on our progress and support hard working NHS staff to deliver faster routine care for patients with the aim of treating nine in 10 within 18 weeks by the end of this Parliament.

The radical reforms in this plan will not only allow us to deliver millions more tests, appointments and operations, but do things differently too – boosting convenience and putting more power in the hands of patients, especially through the NHS app.

The reforms set out today are focused on doing things differently by putting patients first, looking at their treatment in the round and empowering them with more choice and control so that care is more convenient and fits better into their lives. 

Further measures include:

• Using the NHS app to give patients greater choice and control over their treatment. 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.
• Preventing unnecessary referrals. GPs will be funded to work with hospital doctors to get specialist advice before making referrals, so that more patients get the care they need without being referred onto the waiting list.
• Giving patients choice over non essential follow up appointments as part of a drive to free up around 1 million appointments a year for those who need them. 
• Making more appointments available in the community instead of hospitals. More treatment for five specialties with particular pressure on waiting lists will also be made available outside of hospital through targeted reforms, including Ear Nose and Throat services, where around 30% of referrals currently made to secondary care could be provided in the community.
• Making convenience for patients a priority through the roll out of innovative ‘collective care' approaches, for example, one stop clinics where patients can be assessed, diagnosed or reviewed on the same day; where appropriate, offering group appointments where patients with long term conditions may benefit from being supported together; opening ‘super clinics' which bring together a wider range of clinicians to oversee patient care under the oversight of a consultant, increasing the number of patients seen in a day.
• Driving up patient experience through a set of national standards for elective care. We will publish minimum standards that patients should expect to experience in elective care, including giving patients a shortlist of providers to choose from and clarity on how long they are likely to wait. In turn these standards will make it easier to identify where performance is falling short and how to improve it.

Harnessing the benefits of new technology and AI is a central part of the government's mission to rebuild the NHS. Healthcare providers will be supported through these reforms to use technology to tackle inefficiencies holding up appointments. 

For example, focused action across the healthcare system - including drawing on predictions by AI on which appointments are most likely to be missed – will help save up to 1 million missed appointments. Remote monitoring technology – for example, using wearable tech to collect vital health data on patients without them having to see a healthcare professional face to face – will also be deployed more widely to help provide more personalised and more efficient care, ensuring appointments are scheduled because of clinical need, not just at routine intervals.

Reform will also tackle deep seated structural issues which have held back improvements to date by bringing funding mechanisms, performance oversight and delivery standards together with incentives for positive change. This will ensure the system is set up in a way that rewards and actively drives improvements. 

Trusts who make the fastest improvements in cutting waiting times will be rewarded with additional funding for capital projects tailored to local needs. This could include investment in cutting edge AI diagnostic equipment or hospital ward maintenance. 

There will also be greater transparency on performance and support in place for providers facing the greatest challenges, and new support for clinical and operational leaders on how to deliver more effective elective pathways. 

The plan will also provide greater funding certainty, to help commissioners deliver their operational planning with more stability over their finances. 

Tackling waiting lists is the first step in the government's mission to build an NHS fit for the future, as set out in the Plan for Change. 

At the heart of this mission are three big reform shifts, which will be central to the 10-Year Health Plan currently being developed in consultation with NHS staff and the wider public and set to be published in spring 2025: hospital to community; analogue to digital; and sickness to prevention.

These are fundamental and necessary reforms in the way our health services deliver care and address the inherited challenges facing the NHS that Lord Darzi identified in his report published last year.