What did Coffey announce? She said she would be a “champion” for patients and would have “a relentless focus on measures that affect most people’s experience of the NHS and social care”, particularly long waits. Her speech included some new initiatives, but also referred to many policies already in place. The move that attracted the most attention was its “expectation” that anyone seeking a GP appointment should get one within two weeks – currently 15% of patients do not – and that GPs should give the most sick patients per day time slots. But GP leaders and health policy experts said a shortage of family doctors would make it difficult to deliver on both these ambitions. What is he going to do to get patients out of the hospital? Around 13,000 of England’s 100,000 hospital beds are occupied by people who have been judged fit to leave but cannot be discharged, usually because there is no social care available they are safe at home or in a care home. NHS bosses are desperate for these beds to be freed up as soon as possible. Coffey’s solution? Create a £500m ‘adult social care exemption fund’. This money will be used to pay nursing homes and domiciliary (in-home) personal care service providers to care for patients who would otherwise needlessly be kept in hospital. Although billed as “new”, the fund is essentially a renewal of the “exemption for assessment” fund. It performed the same function successfully but was scrapped at the end of March, despite NHS leaders warning ministers not to do so. How was the new fund received? With a single cheer. NHS trusts have welcomed it but want to know where the £500m is coming from. This remains unclear. Tim Oliver, the chairman of the County Council Network of 36 mainly Conservative local authorities, said the fund was “a step in the right direction”. But, he added, “with councils facing inflationary costs of £3.7bn this year and next, [it] falls short of what is required. [It] it will help with hospital discharge but will not address other issues within the care system, such as over 500,000 people on care waiting lists [and] chronic staff shortages, with over 160,000 vacancies’. Age UK fears it could result in newly discharged patients being prioritized for help from care providers in difficulty over equally needy people currently receiving it. Did Coffey scrap the four-hour A&E target? No. Some stories that appeared before her speech suggested she could soften or even scrap the NHS’s best-known target – the duty on hospitals to treat and then admit, transfer or discharge within four hours patients who have attended A&E. But he didn’t. Instead, he told MPs: “I can definitely say that there will be no changes to the target for four-hour waiting times in A&E.” Wes Streeting, the shadow health secretary, had asked her to confirm “that her response to the crisis in the NHS will not be the lowest standards for patients”. Excavating the target would have sparked a streak. The Health Service Journal reported that Coffey’s decision to retain it “represents a significant blow to NHS England, which from 2019 has been pushing for a new set of measures to replace [it]’, and it was a break from her predecessors, Sajid Javid and Matt Hancock, who both looked to replace the supposed maximum wait.
