Lizzy Buchan: A review of NHS targets should be welcomed

It's time for a mature discussion on how to alleviate pressures in a system that is clearly unsustainable, writes Lizzy Buchan

The current system heaps pressure on staff, who are already stretched due to high levels of vacancies in almost every area of the health service. Picture: PA

From waiting times in A&E, to diagnostic tests and cancer scans, the Scottish NHS has a target for almost everything.

These standards were brought in to transform the way the health service performs and there have been plenty of encouraging signs of progress.

However the 19-strong roster of targets has attracted criticised for causing problems rather than solving them.

Health secretary Shona Robison’s announcement of a wholescale review of NHS targets this week was sure to generate interest as the measures continue to divide opinion.

Many doctors and nurses dislike the system because they say it skews priorities towards the political rather than the clinical.

The Royal College of Nursing and the British Medical Association have both called for a rethink over claims the targets focus energy on the wrong things and encourage waste of resources. For example, the flagship Treatment Time Guarantee, which promises elective surgery within three months, is constantly missed despite the fact it is enshrined in law.

So NHS boards pour money into sending people into the private sector for these operations and divert resources from elsewhere.

The system also heaps pressure on staff, who are already stretched due to high levels of vacancies in almost every area of the health service.

These targets represent standards all hospitals should be hitting but in reality this is not the case.

Well-performing health boards can struggle on waiting times for pyschological services, while some hospitals are excellent in many areas but fall down on guaranteeing prompt outpatient treatment.

The argument for targets is they can highlight where the problems are within a large and complex picture.

This week alone revealed that 100 children in Lothian had faced waits of more than a year for mental health treatment, despite the target promising 90 per cent of patients would be seen in 18 weeks.

Urgent cancer treatment targets were missed by all but three health boards last year, shining a light on the concerning disparities between different regions.

Opposition politicians rightly say that the SNP cannot ditch the standards it does not like to make NHS performance seem stronger.

But there is an important discussion to be had over whether every one of these 19 targets is necessary.

People deserve access to prompt treatment but flooding resources towards ticking boxes may not be the most effective way of ensuring the best care for patients or the greatest efficiency for the NHS.

Medical leaders have been calling for the targets to be scrapped for some time and now is the moment to listen to what they have to say.

You cannot measure how many times a nurse cheers a patient with a smile or makes an extra effort to preserve their dignity in difficult moments.

Nor can you quantify when a doctor learns every single patient’s name and spends hours making sure they understand their treatment.

This must not be an exercise in reducing transparency but rather a mature discussion on how to alleviate pressures in a system that is clearly unsustainable.