Darzi: NHS ‘unlikely’ to meet performance targets in five years

The former Labour minister made his downbeat verdict on the party’s key manifesto pledge in his government-commissioned review of NHS performance, published today.

The wide-ranging 142-page report, an Independent investigation of the National Health Service in England, details a litany of problems, and places much of the blame for them on a lack of investment by the last government, particularly in capital and infrastructure.

On key areas covered by constitutional waiting time standards, the report sets out how cancer targets have not been met since 2015, long waits for elective care have been “normalised”, and A&E “is in an awful state”.

The review concludes: “I have no doubt that significant progress will be possible [on waiting times] but it is unlikely that waiting lists can be cleared and other performance standards restored in one parliamentary term. Just as we in the NHS have turned around performance before, we can do so again.”

This is in sharp contrast to comments before the election by Wes Streeting, now health and social care secretary, that Labour was committed to restoring all constitutional performance standards – covering elective, A&E, cancer and ambulance services – in a first term in office.

Mr Streeting said at the time: “We know that these are challenging [commitments]. If I think about the range of performance standards, we know that on UEC [urgent and emergency care], that’s a tougher challenge than on the elective backlog…

“That’s why we’ve been working with some of the best minds across the system to help us [on emergency care delivery]… and that’s what’s given us the confidence to make that commitment.”

HSJ asked the Department of Health and Social Care last night if the government stood by that commitment, considering Lord Darzi’s verdict. It had not directly responded to the question at the time of publication.

Analysis by waiting list expert Rob Findlay for HSJ published in May suggested Labour’s election pledge to restore the 18-week elective target within five years is feasible.

However, the 95 per cent standard for the four-hour A&E target has long been viewed by NHS leaders as a target which will not be met again without huge investment in hospital capacity, for reasons set out in this HSJ editorial from April.

Lord Darzi’s report does not appear to propose ditching any of the constitutional standards – despite NHS England spending several years trying unsuccessfully to do precisely this as part of its ‘clinical review of standards’ which was launched in 2019, with the four-hour A&E target their main priority for reform.

In a media statement about Lord Darzi’s review, Mr Streeting said: “Today’s findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.

“The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead. But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again.”

NHSE chief executive Amanda Pritchard said: “While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.”