NHS England has proposed introducing “minimum waiting times” for certain elective specialties as system leaders grapple with how to balance clinical needs and a real terms funding cut for local services.
The proposal was revealed in changes to the NHS Standard Contract for 2025-26, published by NHSE on Thursday, following the decision to ditch plans for a fixed cap on providers’ elective activity earnings. This was how government and NHSE had planned to control costs in 2025-26, but it was branded “unworkable” by providers.
However, the Nuffield Trust warned the new proposals – out for consultation with a 28 April deadline – gave “no clear process to rationally decide which forms of activity it is least harmful to hold down and which, if necessary, should be permitted to exceed plans”.
The new contracting plan is based on the principle of commissioners agreeing “robust indicative activity plans” with providers under arrangements NHSE said required “material changes [to the] contract activity management provisions”.
The document also confirms that NHSE is proposing the introduction of minimum waiting times where local commissioners view this as appropriate. It is due to concern some providers carry out a large volume of certain procedures with short turnarounds – for example a few days – while commissioners may be unable to afford to address much longer waits for other services.
The plan says commissioners could set “activity planning assumptions” about “how the particular provider will manage activity once a referral has been accepted”.
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Source: HSJ, 11 April 2025
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