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Royal College of Surgeons response to NHS Long Term Plan

07 Jan 2019

Responding to the NHS Long Term Plan published today, Professor Derek Alderson, President of the Royal College of Surgeons, said:

“There is much to welcome in this long-term plan and it is right that the Government and NHS England continue to project an ambitious vision of healthcare. 

“The emphasis on primary and community care, and reducing unnecessary outpatients appointments, is long overdue. Better out-of-hospital care should benefit patients needing surgery by reducing pressures on hospitals, thereby freeing up capacity. It is essential this approach is backed up by social care reform which currently remains in no-man’s land. 

“However, health service leaders need to guard against the potential risk of focusing on primary and community care at the expense of hospital care. Demand for hospital treatment, including surgery, continues to rise and many patients still turn to A&E rather than make use of new community services which they can be unfamiliar with. 

“It is of greater concern that there is no clear timeline for meeting the 18-week target for operations and planned treatment. There is little emphasis at all on reducing waiting times for patients except for those waiting longer than a year. The target is increasingly forgotten; the emphasis is instead on making sure patients are seen within one-year and reducing the overall size of the waiting list. We must not forget that the target was partly introduced to avoid a postcode lottery in access to surgery and provide some reassurance to patients about when even minor conditions could be treated. There is therefore a risk that focusing on one-year waits will lead to much greater variation in waiting times across the country. Patients in pain needing a heart, brain, or any other type of operation will wonder how a longer wait fits with today’s vision of an improving health service. 

“While we support plans to review the existing targets, particularly to see whether those in greater clinical need can be treated more quickly, we would not support changes that do not assure patients that they will be seen quickly. 

“Many staff are feeling burnt out by the ongoing pressures in the NHS and may be understandably cynical about whether today’s plans are attainable. This underlines the need for a much greater emphasis and urgency on resolving the current workforce pressures. We call on the government to publish a detailed workforce plan as soon as possible.” 


Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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