What are the key NHS targets?
There are the three main NHS targets related to physical health. They are sometimes called ‘Key Performance Indicators’ (or KPIs). They are:
This is current performance data mainly from the House of Commons library (July 2024).
4 Hour A&E Target
Known as ‘4 Hours’, this is for emergency care. It states 95% of emergency patients should be seen, treated if necessary, and either discharged or admitted, within four hours from arrival at the emergency department (ED).
4 hours was last achieved in July 2015. Currently 60% achieve the 4 hour target. This means almost all patients going through ‘majors’ (the sicker patients) will breach the 4 hour target.
18 Week Referral to Treatment (RTT) Target
Known as ’18 weeks’, this is the key target for elective (i.e. planned) care, especially operations. In other words, 18 weeks is the maximum waiting time for non-urgent, consultant-led treatment in NHS (e.g. CKD or a hip replacement). 92% of patients should achieve it. It is also known as ‘18 weeks’. It is measured from the day from when the GP refers the patient to the start of treatment (or the decision not to treat).
Of these, about 300,000 of these patients have been waiting over a year for treatment, with a median waiting time for treatment of 14.3 weeks – almost double the pre-COVID median wait of 7.5 weeks in June 2019.
18 weeks was last achieved in February 2016. Currently (Feb 2024) 58% achieve the 18 week target.
Cancer targets: 2 Week and 31/62 Day Targets
In England, if a GP suspects cancer, at least:
- 93% should see a hospital consultant within a ‘2 week wait’ (2WW), from when the GP’s referral arrives at the hospital. This is being changed to a 28-day ‘Faster Diagnosis Standard’
- 96% should wait no more than 31 days from receiving diagnosis to first treatment plan (31 days)
- 85% should wait no more than 62 days to have ‘First Definitive Treatment’ (e.g. an operation or chemotherapy or radiotherapy) from arrival of original referral letter (62 days)
2WW was last achieved in December 2015. Currently 92% of patients achieve the 31 day target and 66% achieve the 62 day target.
Extended wait times have a significant correlation with poor patient outcomes, more errors, diminished patient satisfaction. This not only affects the patient’s health but also leads to increased healthcare (and economic costs in the long-term).
All of this leads to huge frustration amongst patients.
Note 1. Most of the data above is for England. Targets are different in the 3 nations, though performance is similarly poor
Note 2. In England the cancer targets are now changing. The 2WW target was changed for a 28-day faster diagnosis standard in Oct 2023
Note 3. There are no well-known GP targets. MyHSN thinks there should be.
And there are three main targets related to mental health:
Counselling
75% of people referred to IAPT (counselling) programmes should begin treatment within 6 weeks of referral, and 95% within 18 weeks
Psychosis (severe mental illness, e.g. schizophrenia)
For those having their first episode of psychosis, 50% should receive NICE-recommended treatments within 2 weeks of referral
Eating disorder
95% of children and young people (up to the age of 19 years), referred for assessment or treatment for an eating disorder, should receive NICE-approved treatment – within 1 week if the case is urgent, and 4 weeks if the case is non-urgent.
Most of these targets are your legal right under the NHS Constitution.
Summary
We have explained what are the key NHS targets. They are the 4 hour A&E target, 18 week Referral-to-treatment (RTT) target, and the 31/62 day Cancer Targets. There are no well-known GP targets. There should be.
4 hours, 18 weeks and the 2WW were last achieved in July 2015, February 2016 and December 2015 respectively. And the two week target is now becoming a 28 day one.
We are very sorry that we are not hitting them at present. The British public deserve more. We will try our best to improve.
