NHS England told to scrap improvement pledges and prioritise cutting waiting times

NHS England is scrapping plans to diagnose more cancers early, boost women’s health and ramp up childhood vaccinations after ministers told it to prioritise cutting waiting times.

The health service is also abandoning pledges to expand access to dental treatment, give more people drugs to prevent strokes and enhance care for those with learning disabilities.

Under the changes, care providers will also drop commitments to increase the number of people diagnosed with dementia, offer patients more choice about where they are treated and expand the use of talking therapies for those with anxiety and depression.

Health experts and charities criticised the plans. They warned that the shift in priorities was out of line with the government’s ambition to improve the health of the nation and would prove damaging and even “dangerous” for some groups of patients.

Wes Streeting sought to allay such concerns by ordering the health service to concentrate on delivering shorter waiting times for A&E and cancer care and hospital treatment. Hundreds of thousands of people are expected to benefit from faster access and diagnosis. Surveys have shown that long delays for NHS care are the public’s greatest concern.

The health secretary announced the overhaul when he handed the NHS its mandate and planning guidance – the “success measures” it must focus its energy and resources on – for 2025-26. He has cut the NHS’s list of priorities from 32 for 2024-25 to just 18 for the next financial year.

“This new approach will see the NHS focus on what matters most to patients – cutting waiting lists, getting seen promptly at A&E and being able to get a GP appointment,” Streeting said.

But that did not head off criticism from health groups. Dr Sarah Hughes, the chief executive of the charity Mind, accused ministers of “deprioritising mental health” after an array of schemes to improve care were dropped. They included plans to give 75% of those with severe mental illness an annual physical health checkup, ensure at least 700,000 people a year complete a course of psychological talking therapies, and expand maternal mental health support to at least 66,000 women.

Obstetricians and gynaecologists said the abandonment of plans to ensure each of the 42 NHS regions in England has a dedicated women’s health hub by last December was in breach of Labour’s election manifesto commitment to prioritise women’s health. However, 39 of the 42 integrated health boards already have at least one.

The 14 dropped targets also include getting 80% of those with high blood pressure on to statins, giving 75% of people with learning disabilities an annual check-up and increasing childhood vaccination rates – which have fallen in recent years – to levels recommended by the World Health Organization.

“Reducing the overall number of national NHS targets is not necessarily a bad thing,” said Sarah Woolnough, the chief executive of the King’s Fund thinktank.

But, she added: “Setting a relatively large number of goals for hospital care, while losing targets for childhood vaccination and the offering of medicines to people at risk of cardiovascular disease appears to be at odds with ministers’ ambition to prevent illness and not just treat it.”

The previous plan to increase the amount of dental activity undertaken by the NHS has been replaced for 2025-26 with a more limited pledge to expand the number of urgent dental appointments.

Dr Becks Fisher, director of research and policy at the Nuffield Trust, said: “Improvements in dentistry are long overdue, but today fewer than half of adults actually receive NHS check-ups, and the targets in this guidance will not meaningfully change that.

“Given that the NHS cannot cover everyone on this budget, it is not clear that more emergency appointments should be the priority. People who cannot afford private care, or who need prevention to avoid worse problems, should come first.”

Fiona Carragher, of the Alzheimer’s Society, said she was “shocked” that the target to improve diagnosis of dementia was not in the new guidance.

Jon Sparkes, the chief executive of Mencap, said: “Scrapping vital NHS targets for people with a learning disability is a dangerous step backwards.”

The new instructions to NHS England will also force it to shed 2,000 jobs as part of a drive to make £325m in savings next year, while the service as a whole has been told to reduce its costs by 1% overall – about £1bn.

“In what will undoubtedly be another tough financial year, the NHS will continue its relentless focus on boosting productivity and driving efficiencies for the benefits of patients and taxpayers,” said Amanda Pritchard, NHS England’s chief executive.