More choice to help cut hospital waiting times

Patients will be empowered to choose where they receive their NHS care under new plans to help cut waiting lists, one of the Prime Minister’s five priorities.

A letter issued by the NHS today to local areas will require patients to be offered choice when clinically appropriate.

After speaking with their GP, patients will be able to view information for up to five healthcare providers - filtered by distance, waiting times and quality of care. They will then be able to make a choice about where they go for treatment using the NHS App or website, based on their own circumstances.

Currently just one in ten patients exercise their right to choose but research shows that giving patients choice can cut up to three months off their waiting time by selecting a different hospital in the same region.

During the pandemic, millions of people downloaded the NHS App to access services including the NHS COVID Pass. The plans announced today will expand the way that the NHS App and website are used to improve how patients choose to receive their care. Newly updated software to IT systems will also make the process easier for GPs when referring patients for treatment.

The Prime Minister, Rishi Sunak, said:

“Empowering patients to choose where they receive treatment will help cut waiting lists, one of my five key priorities.

“Currently, just one in ten patients make a choice about where they receive care. We want to change that by helping the NHS to offer patients a real choice while also giving patients the information they need to decide.

“Our aim is to create an NHS built around patients, where everyone has more control over the care they receive, wherever they live or whatever their health needs are”.

Health and Social Care Secretary Steve Barclay said:

“Every patient should be able to easily choose where they go to receive treatment and today’s package will put that power in their hands.

“Millions of people downloaded the NHS App during the pandemic. Increasing use of this fantastic resource will enable them to exercise more choice and get access to essential information about the options for their care including journey time, length of wait and quality of service – all at the swipe of a smartphone screen.

“This will not only give patients more control over their own care but could also wipe months off their wait by finding a hospital or clinic with a shorter waiting list.

“Cutting waiting times is one of the government top five priorities and we are already making progress to tackle the backlog and are rolling out community diagnostic centres and surgical hubs to boost the numbers of tests, scans and operations.”

Patients already on waiting lists will also benefit as, from October, those who have waited more than 40 weeks for an appointment but have not yet been given a treatment date, will be asked whether they want to switch hospitals, including one with a shorter wait, if possible and clinically appropriate. This builds on existing NHS ‘mutual aid’ arrangements between hospital trusts.

As the NHS continues to make progress in tackling the backlog, this threshold could be reduced over time, based on clinical advice, towards 18 weeks as fast as possible.

A new public awareness campaign will also encourage patients to exercise their right to choose and guidance has been provided to GP practices to support them to offer choice, with training available on using IT systems to make referrals.

Amanda Pritchard, NHS chief executive, said:

“By giving patients greater choice and more information about their care through the convenience of the NHS app, we can change the way people access treatment options while also building on the fantastic work already being done by NHS staff across the country in bringing down the longest waits for care.

“Despite significant pressure, the NHS reduced 18 month waits for care by more than 90% by April and alongside existing tools like elective hubs, surgical robots and ‘prehab’ checks, this is another way that we are continuing to embrace the latest innovations and tech for the benefit of patients.”

Joe Harrison, Chief Executive at Milton Keynes University Hospital NHS Foundation Trust, said:

“Staff at NHS trusts across the country have been working flat out to reduce the amount of time patients are waiting for elective treatment, and are making incredible progress.

“Giving patients even more access to information about their appointments, and being able to choose where they take place through the convenience of the NHS app, will help trusts continue to provide patients with the best possible care, as quickly as possible.”

The NHS App, which serves as a digital front door to the NHS, has over 32 million sign ups and receives around 75 million visits a month. Patients are already able to book and manage their GP appointments, order repeat prescriptions, and manage their hospital referrals through the App.

Dr Sarah Clark of Westgate Surgery, Otley, said:

“As a GP I know how important it is for our patients to have the choice in where and when they are treated. Patients have different priorities and different needs and offering choice better fulfils that need.

“By extending the options for patients they will be able to choose to be seen quicker or in more convenient locations for them. Hopefully this will, in part, help reduce the wait for secondary care referrals but also reduce the number of appointments not attended by patients who have been given no option over where or when they are seen.

“This change will be embraced by my patients and is something which I, as their GP, support.”

Rachel Power, Chief Executive of the Patients Association, said:

“We hope this announcement will make it easier for patients in England to use their long-established right to choose where they receive their care.

“Work we’ve done shows patients’ awareness of choice is not high, nor are many offered choice regularly. Earlier this year, our survey of patients’ experience of healthcare found around only 1 in 6 patients we questioned had been given the opportunity to choose where they had their hospital care.

“We hope the planned communications campaign will clearly explain choice and encourage people to exercise it. We welcome news of the support general practice is to get, but with the current pressures on general practice, it will be important they are supported to work in partnership with their patients to increase uptake of patient choice.

“We hope the planned changes will lead to more patients exercising their right to choose where they have their treatment, enabling them to access and benefit from the healthcare they need to live well.”

David Hare, chief executive, Independent Healthcare Providers Network:

“We welcome today’s announcements from the Government, and patients will too.

“An awareness campaign to help the public understand their rights to choose is good news. We know many patients want to be given a choice as it can dramatically reduce their wait for NHS care. But too often patients are unclear that they have the right to choose a health care provider to deliver their NHS care – whether an NHS organisation or an independent sector one – free at the point of use.

“Delivering new ways for patients to use the NHS App to choose and progress their care is a very exciting development. It’s great to see this functionality and capability being rolled out. Millions of people downloaded the app during the pandemic, so using this technology will really help modernise how we access healthcare, putting control into the hands of patients themselves.”

Significant progress has already been made in bringing down waiting lists for patients - the NHS successfully met the first target in the Elective Recovery Plan to virtually eliminate waits of over two years and has cut 18 month waits by over 91% from the peak in September 2021.

Background
Integrated Care Boards have been asked to ensure travel is not a prohibitive factor There is a longstanding policy in the NHS that if you are eligible you may be able to claim a refund for reasonable travel costs. That scheme - Healthcare Travel Costs Scheme – will continue to apply.
For patients who do not have access to technology, either their GP practice will speak to them and help select their provider, or they can call the ‘National Referral Helpline’) who will be able to talk the patient through their shortlist and support finalising their choice and onward referral.
A report led by the Patients’ Association in partnership with the independent sector in July 2022 found that a patient would need to travel just 13.2 miles to go from one of the worst performing providers to one of the top performers. Doing so could save patients 14 weeks of waiting if they move from providers with an average waiting time of 22 weeks to one with an average of 8 weeks: How patients exercising their right to choose can help clear the NHS elective backlog
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