Patients are being put at risk and suffering harm due to the continued failure to hit NHS waiting-times targets, MPs say.
A damning report from the Public Accounts Committee (PAC) criticises both the Department of Health and NHS England for the “unacceptable” situation, and the “downward spiral” in the proportion of patients seen.
Furthermore, MPs said the Department of Health and Social Care “has allowed NHS England to be selective about which standards it focuses on, reducing accountability”.
NHS England has told MPs it has removed sanctions and penalties against NHS trusts for failing to meet waiting-times targets.
The NHS Constitution gives patients the right to access services within maximum waiting times, with 92% of patients expected to start treatment within 18 weeks of referral by their GP for planned care such as hip operations.
However, the target was last met in February 2016. The most recent data for March shows just 86.7% of patients were seen within the target and only four out of 10 trusts hit it.
The NHS waiting list has also grown hugely and is up 1.5 million on 2013 to stand at 4.2 million people waiting in March 2019.
On cancer, the target says 85% of patients should start treatment within 62 days of an urgent referral by their GP, but this was last met in December 2015.
In March this year, only 79.7% of patients were treated within the timeframe, and only 42% of trusts met the target.
The MPs’ report said the national health bodies “lack curiosity” about the impact on patients of longer waits, and how often this leads to patient harm.
“When waiting times are longer, patients may experience additional pain, anxiety and inconvenience,” MPs said.
“There is also a risk that longer waiting times may lead to patient harm through, for example, the deterioration of a medical condition.
“The NHS has a very limited understanding of this issue.”
While individual hospitals may carry out harm reviews due to long waiting times, the data is not collected at a national level, the report went on.
“NHS England is aware that some patients have suffered harm due to long waits and that research on the relationship between patient harm and waiting times is not consistent.”
MPs said national bodies “do not yet fully understand what is driving the demand for elective care” and cannot therefore plan to meet future need.
NHS England is currently reviewing NHS targets and could scrap both the 18-week target and the four-hour A&E target.
PAC chairwoman and Labour MP Meg Hillier said: “It is unacceptable that the proportion of patients being treated within NHS waiting times standards is continuing to spiral downwards; NHS England and the Department of Health and Social Care must regain control.
“The impact on individuals of protracted waiting times cannot be ignored.
“In a high-pressured healthcare environment in which patient numbers are rising and demand is increasing, we were troubled by the Department’s and NHS England’s approach to waiting times which seems to be characterised by gaps in understanding of patient harm, hospital capacity and what is driving demand.”
She said NHS England’s current review of waiting times targets “cannot be an opportunity for standards to slip”.
Rachel Power, chief executive of the Patients Association, said: “This is an ongoing and deeply concerning problem with serious consequences for patient care, and it is simply unacceptable for patients to be left in limbo in this way.
“Longer waits always mean more time spent in pain and discomfort, but for some procedures they also reduce the good that the treatment is likely to do for the patient – this must be understood in terms of human cost, not merely numbers, however dramatic.”
Siva Anandaciva, chief analyst at The King’s Fund, said: “We must not lose sight of the fact that NHS ‘waiting lists’ are made up of people; over four million people who may be living in pain, who will be seeking help from other services such as GPs or pharmacists.”
Jonathan Ashworth, Labour’s shadow health secretary, said: “This report is a reminder that years of Tory underfunding and understaffing has left patients increasingly anxious and worried for test results, and will be forced to wait longer for vital treatment.”
A Department of Health and Social Care spokeswoman said: “Over a million NHS patients start planned treatment with a consultant every month – with the majority seen and treated within 18 weeks – and last year 71,000 more people began their cancer treatment than in 2010.
“We’re providing an extra £33.9 billion a year by 2023/24 through the NHS Long Term Plan which will see the health service grow the amount of planned surgery year on year and reduce the waiting list.”