Healthcare delivery
satisfactorily reach all patients, as there is likely to always be a part of the population who find digital technology and tools too difficult to use.
Conclusions and recommendations Below are the PAC’s conclusions and recommendations: 1. Too many people are still waiting too long for diagnostic tests and treatment, and the pace of change to meet recovery targets is too slow.
Recommendation NHS England and the Department for Health and Social Care should: a. set out their plans to reach the 1% operational standard for six week waits for diagnostic tests. b. set out the actions they have taken to monitor and address risks associated with long waits and on disparities in waits between groups of patients.
2. NHS England’s plans to transform outpatient services were not credible, even though it had already acknowledged that more efficient outpatient services would make a material difference to the waiting list.
Recommendation NHS England should set out what it has learned from the failure of the outpatients programme and use this to inform its plans for the future of the programme. These plans should include, at a minimum, the setting of meaningful targets for which it has clinical support, ensuring it has senior clinical leadership in place to secure clinical engagement, and strong governance and reporting arrangements.
3. NHS England’s approach to transformational change was deeply flawed in both monitoring of progress and the delivery of intended outcomes.
Recommendation The Department of Health and Social Care and NHS England should: a. Set up data collections or processes for tracking costs and benefits as early as possible when setting up new services or transforming existing services including the recent extension of specialist telephone advice to GPs. b. Focus reporting on the achievement of policy aims (expected outcomes for patients) to ensure that the capital funding provided delivers intended outcomes.
4. PAC is not confident that the Department is being realistic about the immense effort needed to reduce NHS elective care waiting times, and see a significant risk that digital solutions are being treated as a ‘cure-all’ as the 10-Year Plan is being implemented.
Recommendation NHSE and the Department should set out: l How the elective care transformation programmes are practically affected by the ‘analogue to digital’ shift in the 10-Year Plan;
l How it will solve the problem of legacy IT equipment and ensure that the IT systems used in different parts of the NHS are properly connected; and
l Whether the 10-Year Plan itself has sufficient funding to deliver the digital transformation required by the plan.
5. NHS England’s performance to date has not demonstrated that it can secure the clinical engagement that will be necessary to transform waiting lists.
Recommendation The Department should set out what it plans to do differently to secure clinical engagement on the outpatients transformation programme to improve waiting times.
6. PAC is concerned that the Department for Health and Social Care and NHS England are still announcing major reforms without either delivery plans or secured funding. It does not accept that it is prudent to make a major change, such as the structural
January 2026 I
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