Can Starmer's Vision for NHS Waiting Lists Really Deliver Change?

In a renewed commitment to addressing the NHS backlog, Prime Minister Sir Keir Starmer has unveiled a plan focusing on reducing waiting lists, recognized as one of the government’s top priorities. However, the viability of this strategy raises questions due to limited action levers available to ministers and the reliance on ongoing initiatives initiated before the pandemic.

Among the key features of Starmer’s proposal is the expansion of surgical and diagnostic hubs in communities, which aim to provide more care outside of traditional hospital settings. Despite the expected increase in the number and operating hours of these facilities, the British Medical Association has pointed out that staffing shortages could severely hinder progress.

Additionally, Starmer promotes giving patients more autonomy in choosing their treatment locations, suggesting that patients could opt for facilities with shorter waiting lists. Although this initiative echoes previous health policies dating back to the Blair administration, the uptake remains disappointingly low, with only about 25% of patients currently presented with choices.

The situation is further complicated by the government’s long-standing strategy to utilize the independent sector. The private sector claims it has capacity to handle 30% more NHS patients, but historically, it tends to focus on simpler procedures, which may strip NHS hospitals of essential income and training opportunities for medical staff.

While there is an optimistic expectation that the backlog will begin to decline in the coming months, hitting the ambitious target that 92% of patients are treated within 18 weeks by the end of the current parliament remains a significant challenge. This target has not been met since 2015, with less than 60% of patients currently receiving timely treatment.

Historical increases in NHS funding, which bolstered progress under the Blair government, are highly unlikely given the current state of public finances, with a critical spending review anticipated in spring. Moreover, there are concerns that a singular focus on waiting lists could detract from other vital NHS services, such as GP access and emergency response times. As Sarah Woolnough from the King’s Fund warns, the waiting list metric shouldn’t overshadow other critical performance areas within the NHS.