NHS orders hospitals to cut back on treating patients

Access to hospital treatment is limited in many areas of England as the National Health Service struggles to balance its books, the BBC has learned.

Regional health boards have ordered some hospitals to reduce the number of patients they accept, meaning hundreds of thousands of patients will have to wait longer for treatment.

The rationing measures apply mainly to private firms carrying out NHS work, but it is expected that several NHS hospitals will also be affected.

NHS managers said they were caught between a “rock and a hard place” as they tried to balance the books with tackling a hospital backlog that currently stands at 7.4 million.

Reducing waiting times for operations such as hip and knee operations and achieving the 18-week waiting time target is the Government's number one priority for the health service.

But documents seen by the BBC show integrated care boards, which are responsible for spending on behalf of NHS England, are asking hospitals to make patients wait longer and reduce the number of patients they treat until the end of the financial year.

One asked a private provider to cut activity by almost 30% and make patients wait an average of eight weeks longer, while stopping new referrals for the time being to reduce the amount of work being done.

A surgeon at a private hospital said they had to cancel all planned NHS surgeries for the coming weeks, with some patients only given a few days' notice.

They told the BBC: “I had a full day of joint surgery scheduled this week and weeks before patients were told their life-changing operations would not be carried out.

“Many of them have been waiting more than 40 weeks for treatment. It's devastating for them.”

Circle, one of the country's largest private hospitals, has said in a letter to its doctors that in some facilities it may have to stop accepting NHS patients altogether.

Daniel Elkeles, from NHS Providers, which represents NHS hospitals, said restrictions were also being imposed on some NHS hospitals, calling it a “real problem”.

“If the government really wants them to meet their 18-week target, they will have to go all out and use all the capacity available, and that will mean more funding is needed.”

Regional health boards use so-called performance management plans to push individual hospitals to reduce the number of patients they admit.

They are primarily used when hospitals are admitting more patients than expected.

They can also be used to push hospitals to provide more treatment when activity levels are lower than expected.

The BBC has seen evidence or received confirmation from multiple health boards that restrictions have been introduced in parts of the North West, North East, South West, Yorkshire, East Midlands and East Anglia.

A number of health boards have refused to provide information to the BBC, and senior NHS sources said they expect many of England's 42 regional councils will now impose restrictions on individual hospitals in their areas.

They said they expected the number of affected hospitals to almost certainly rise before the end of the financial year, adding that strikes by resident doctors had not helped, with the NHS estimating strikes had cost hospitals more than £500 million this year.

It is estimated that the orders imposed on private hospitals, which have already reported, could result in 140,000 fewer patients being treated by the end of March. But given that some NHS hospitals have been affected and not all restrictions placed on private hospitals are believed to have been announced, this may be an underestimate.

David Hare, from the Independent Healthcare Providers Network, said: “Given that demand for treatment in the independent sector depends on patient choice, as well as the scale of the challenge of shrinking NHS waiting lists, we were surprised by the scale of the proposed slowdown, which would leave significant amounts of available capacity unused in both the independent sector and the NHS.”

Rachel Power, chief executive of the Patients Association, said: “These reports are deeply worrying and pose a serious risk to patients' ability to access the treatment they urgently need.

“Calling these 'performance management plans' distracts from what they really are: another barrier standing between patients and timely care.

“This won’t just delay treatment—it will worsen the condition, reduce quality of life and lead to harm that could be prevented.”

Sarah Walter of the NHS Confederation, which represents regional health boards, said its members had had to make some “difficult decisions”.

“The NHS is facing an unprecedented financial challenge, which is forcing system leaders to make very difficult decisions about how limited funding and limited budgets should be spent.

“Leaders are caught between a rock and a hard place as they are tasked with balancing their books and achieving routine care goals.”