News / NHS England cuts elective recovery targets in response to strike action

NHS England has reduced the national elective recovery activity target for the current year in recognition of the impact of industrial action by junior doctors.

The NHS had been set a national target to deliver 107% of elective activity by value in 2023/24 compared to a 2019/20 baseline. However, the national body this week confirmed that this target was now being reduced to 105% as April’s industrial action had affected the amount of activity the NHS will be able to undertake across the full year.

The national body said the reduction was the result of a combination of factors. It has estimated that it cost £25m to provide staff cover for each of the four days of the junior doctors’ strike – a total of £100m. ‘This means some of the money provided to trusts as part of the elective recovery fund to pay for elective treatment is having to be made available to spend on the effects of strike action instead,’ it said in a statement.

Trusts also had to cancel significant amounts of appointments with between 13,000 and 15,000 treatment pathways disrupted each strike day. This will have set trusts back compared with their activity trajectories. The distraction of the strikes has also led to a general loss of productivity and service transformation.

While the downgraded target will mean a two-percentage point reduction in activity this year, NHS England said that the longest waiters and the most clinically urgent cases would still be prioritised. The NHS will continue to aim to virtually eliminate waits of more than 65 weeks by March next year and hit the other targets in the elective recovery plan, it added.

Elective recovery funding within ICB allocations was originally calculated as sufficient to deliver 107% of 2019/20 levels of value-weighted activity – that is 2019/20 activity at 2023/24 unit prices. This was a step up from last year’s 104% target. In practice integrated care boards were set differential activity targets ranging from 103% to 114%, reflecting different starting points and activity levels achieved last year. ICBs delivering the lowest value-weighted activity in 2022/23 were set targets that meant increasing activity levels by more than the national average increase. These differential targets will now be adjusted.

The two percentage point reduction in activity was reported to be worth around £360m.

Matthew Taylor (pictured), chief executive of the NHS Confederation, said the revised elective trajectories were welcome given the significant impact the industrial action had had on efforts to recover services over the last eight months.  ‘However, with trade unions securing fresh mandates for further walk-outs which could stretch into winter, this adjustment will need to be kept under close review,’ he said.

He said the planned strikes by junior doctors, consultants and radiographers this month would also hit trusts hard and having a wider impact in terms of staff burnout and patient care. ‘If the government is committed to reducing waiting lists and supporting the workforce, it has to do everything within its grasp to find a resolution to its dispute with the unions and ensure that any pay increase is fully funded.’