UK Health Secretary offers waiting list support to Wales and Scotland

The UK Health and Social Care Secretary has invited the devolved administration for talks to discuss lessons learnt and tackle waiting lists across the UK

The UK Government Health and Social Care Secretary Steve Barclay has written to the devolved administrations inviting them for talks about how all parts of the UK can work together to tackle long-term waiting lists in all parts of the UK.

NHS services across the UK are a devolved matter, but Prime Minister Rishi Sunak has made cutting waiting lists a priority across the UK. Although approaches taken across England, Scotland, Wales and Northern Ireland share many common features, significant variations in outcomes exist.

In Wales, more than 73,000 people are waiting over 77 weeks for treatment, and at least 21,600 people are waiting over 78 weeks for an outpatient, day case or inpatient appointment in Scotland. In England, waiting times for patients over 78 weeks have been virtually eliminated.

The Secretary of State is inviting health ministers from the devolved administrations to discuss what lessons can be learnt from the different approaches taken.

In England for example, NHS patients are offered a choice of provider at GP referral – NHS or independent sector – provided that it meets NHS costs and standards. And from October we will proactively notify patients waiting over 40 weeks for treatment of their right to choose to be treated elsewhere.

In his letter, the Secretary of State writes that he would be open to requests from the devolved administrations to allow patients in Wales and Scotland who are waiting for lengthy periods to choose to be treated at providers in England, NHS or independent sector – building on the current arrangements for cross-border healthcare.

The Secretary of State has also asked UK health ministers to discuss how health data can be made more comparable across the UK. Northern Ireland official counterparts have also been invited to the ministerial meeting.

Health and Social Care Secretary Steve Barclay said: “I hugely value being able to share knowledge and experiences on the joint challenges facing our healthcare systems. I want to support collaboration between our nations to share best practices, improve transparency and provide better accountability for patients.

“This will help to ensure we are joined up when it comes to cutting waiting lists – one of the government’s top five priorities – and will allow us to better work together to improve performance and get patients seen more quickly.”

The letter reads:

Dear Michael and Eluned,

Thank you for a constructive meeting last month.

As you know, the NHS is at the forefront of people’s minds, and the Prime Minister has made cutting waiting lists a priority to ensure people across the UK get the care they need more quickly. We must continue to take steps to support the NHS and reduce waiting times to ensure no part of the UK is left behind. I am therefore concerned by the variation in performance across NHS services.

As we look to address this issue, it is important that the UK Government and Devolved Administrations work together to ensure that no matter where you are in the country, citizens can access vital services quickly.

In England, we are delivering on the actions set out in the NHS’s Elective Recovery Implementation Plan published last February. Our target to virtually eliminate waits of longer than two years by July 2022 was achieved on time and waits for treatment of more than 78 weeks have been virtually eliminated. Although data is not collected on the same basis across the UK, recent figures show more than 73,000 people are waiting over 77 weeks for treatment in Wales, and at least 21,600 people are waiting over 78 weeks for an outpatient, daycase or inpatient appointment in Scotland.

Whilst there are common features across the approaches of England, Wales and Scotland, one area of difference relates to patient choice. In England, patients have the legal right to choose the provider for their first outpatient appointment (at the point of GP referral) for many healthcare services. Patients may choose to be treated free of charge at any provider – NHS or independent sector – provided they meet NHS standards and costs and hold a contract for the provision of services to the NHS. A Patients Association study has found that this can reduce a patient’s waiting time by up to 3 months.

From October, we will proactively notify patients in England who have been waiting over 40 weeks of their right to request to be treated at a different provider if clinically appropriate, again in the NHS or in the independent sector, provided they meet NHS standards and costs, and they hold a contract for the provision of services to the NHS.

The Secretaries of State for Scotland and Wales share my desire to see patients across the UK have the same rights when it comes to accessing treatment. I would therefore be happy to facilitate a Ministerial working group session (with NI official counterparts) to share how we are implementing this choice approach in England, and to share lessons on work across the UK to tackle the elective waiting list. I would also be open to considering any request from you for patients waiting for lengthy periods for treatment in Scotland and Wales to be able to choose from alternate providers in England – NHS or independent sector – in line with the approach we are taking here, and building on the existing arrangements for cross-border healthcare.

I also believe we need to work together to ensure that health data is more comparable across the UK. It is important that all our citizens can understand the performance of the health services they are receiving and that we can learn from what has been tried and tested in one part of the UK to improve services across the country. I welcome the work our respective teams have been doing to improve data comparability, for example through the Office for National Statistics’ work to improve key UK-wide health performance metrics.

I am very keen to see this work progress and ask for your continued support in prioritising this moving forward.

In the absence of Ministers in Northern Ireland, I am copying this letter to the Department of Health in Northern Ireland and the Secretary of State for Northern Ireland.

Yours sincerely,

RT HON STEVE BARCLAY MP