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Hospitals across England are being instructed to scale back on operations and treatments as the NHS attempts to manage financial pressures, according to information obtained by the BBC. This directive impacts both private providers working on NHS contracts and several NHS hospitals themselves, potentially resulting in significant delays for hundreds of thousands of patients awaiting care. Local health boards have implemented these measures amid ongoing efforts to reconcile budget constraints with addressing a backlog of 7.4 million hospital cases.
The government’s top priority remains reducing waiting times for key procedures such as hip and knee surgeries, aiming to meet the 18-week target for elective treatments. However, documents reviewed by the BBC reveal that integrated care boards, responsible for NHS England spending, are instructing hospitals to extend wait times and limit patient volumes until the financial year’s end. One private provider was reportedly asked to cut back nearly 30% of its activity, increase average patient waits by eight weeks, and temporarily halt new referrals as part of these cost-saving efforts.
Surgeons at some private facilities have faced cancellations of NHS operations with minimal notice. One surgeon shared with the BBC the distressing impact on patients, many of whom had been waiting more than 40 weeks for their joint surgeries. A letter from Circle, one of the country’s largest private hospital groups, warned doctors that some locations might have to cease accepting NHS patients entirely. NHS Providers’ Daniel Elkeles expressed concern that these restrictions also affect NHS hospitals, stating: “If the government really wants them to deliver the 18-week target they would have to go flat out and use all available capacity and that will mean needing additional funding.”
Regional health boards are employing “activity management plans” to adjust hospital patient numbers, primarily when hospitals exceed expected treatment volumes. Although these plans can also encourage increased activity when patient numbers fall short, the BBC has confirmed restrictions are in place across several regions including the North West, North East, South West, Yorkshire, the East Midlands, and East Anglia. Many health boards declined to comment, but NHS insiders anticipate that most of England’s 42 regional boards are now imposing similar limits, with affected hospitals likely rising by the end of March. The impact of recent doctors’ strikes, estimated to have cost hospitals over £500 million this year, has compounded the difficulties faced by the NHS.
Current estimates suggest these directives could reduce the number of patients starting treatment in private hospitals by approximately 140,000 by March, though this figure might be understated due to unreported restrictions and the involvement of NHS hospitals. David Hare from the Independent Healthcare Providers Network highlighted the unexpected scale of the slowdown, noting that patient demand typically drives activity in the independent sector and that underutilized capacity will remain in both private and NHS services. Rachel Power, chief executive of the Patients Association, described the situation as “deeply alarming,” warning that these measures represent significant obstacles to timely care and could lead to worsening health conditions and preventable harm. Sarah Walter of the NHS Confederation acknowledged that regional leaders are forced into “very tough decisions” because of unprecedented financial constraints, balancing the demands of fiscal responsibility against the goal of reducing elective care waiting times
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