TARGETS are aspirations. Applied to health care, they may motivate speedier treatment. But, while speed is often of the essence, sometimes matters are not so simple. Or, as Sir Harry Burns put it yesterday when introducing his long-awaited review of NHS targets: “Clinical practice isn’t like that.”
Sir Harry, the former Chief Medical Officer, was considering targets, such as the legally binding right to receive treatment within 12 weeks of being added to a waiting list and the 18-week Referral to Treatment (RTT) standard, by which 90 per cent of patients should receive an outpatient appointment, diagnostic test (if required) and treatment (where appropriate).
While Sir Harry backed retaining the 12-week limit, he called for clear guidance on ensuring clinical issues are prioritised over meeting the target. And he wants the 18-week RTT standard dropped as it can alter clinical decision making.
In the real world, timescales have to take second place. They put pressure on patients, who may have difficult decisions to make, as well as on clinicians, who find the approach demoralising.
Health Secretary Shona Robison has promised a “more sophisticated approach”, which we hope will encompass Sir Harry’s call for more focus on illness causes and care outcomes and less on timetabling. Quality of care is the only target that matters.
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