NHS should abolish raft of national targets, Patricia Hewitt review says

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The NHS should abolish a raft of national targets while shifting its focus towards preventing ill health, according to a review by a former Labour health secretary.

The study by Patricia Hewitt, commissioned by the Government and officially published on Tuesday, says a few targets help concentrate minds but having too many makes them less effective.

It comes as the NHS continues to miss major targets on A&E waits, ambulance response times and cancer waits and treatment times.

The review will say that adding new targets and initiatives and not being consistent with funding makes it impossible to plan new services and recruit staff, and wastes money and time.

Ms Hewitt will also say that some targets, such as those on A&E waits, leave less room for medics to use their clinical judgment.

Patricia Hewitt
Patricia Hewitt (David Parry/PA)

In her study, extracts of which have been seen by the PA news agency, Ms Hewitt will say ministers should consider significantly reducing the number of national targets, with no more than 10 national priorities.

There should also be more focus on outcomes to improve patient care.

Cutting waiting times for key surgery such as hip replacements and cataract operations should be matched by a focus on cutting waits for mental health treatment, Ms Hewitt will say.

Local leaders running new integrated care systems (ICSs) – which are partnerships of organisations that come together to plan and deliver joined-up health and care services – should be given more space and time to lead.

On preventing ill health, the review will call for the share of total NHS budgets at ICS level going towards prevention to be increased by at least 1% over the next five years.

The public health grant to local authorities should be increased after eight years of a real-terms squeeze on their funding.

This “shift upstream” towards preventative services is vital to prevent more older and increasingly unhealthy people entering hospitals that will never be large or efficient enough to cope, the review will say.

Ms Hewitt will say the NHS is, in practice, more of a national illness service than a national health service and will call for rapid change.

The Government should also consider creating Citizen Health Accounts carrying people’s health information and data, to help people manage their own health and care.

Further details will be set out on Tuesday.

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