NHS management costs are to be slashed and key targets axed, the coalition government has announced.
Health Secretary Andrew Lansley said the changes would help drive down the management bill for PCTs and strategic health authorities.
The four-hour maximum waiting time at A&E is being relaxed, while a target for GPs to see all patients within 48 hours will be scrapped.
The government will also end central scrutiny of the 18-week referral-to-treatment target.
It is hoped the measures will drive management costs down from the current level of £1.85bn to £1bn by 2013-14.
Mr Lansley (pictured) said: "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes."
But the moves were met with caution from patients' campaigners, who fear the changes could mean health providers are not held to account.
But Mr Lansley said:"Doctors will be free to focus on the outcomes that matter – providing quality patient care.
"Patients will still be entitled to rights under the NHS Constitution, and the quality of their experiences and outcomes are what will drive improvements in the future."
Copyright © Press Association 2010
Your comments (terms and conditions apply):
"Removal of TARGETS is long overdue. It is not a reason to offer inferior care as in 'back to the bad old days of your other contributor'. Who knows drs might even have more time to see patients instead of drowning in paperwork and I might have time to drive through improvements instead of doing likewise – now there is a novel idea" – Names and address withheld
"More patient care is needed not targets as these prove nothing. All patients should have the right to see their doctor at the time of need and the doctor should concentrate on his/her medical condition rather then entering figures onto computer system in order to reach their targets" – Name and address withheld
"As a practice business manager in a large general practice, I wholeheartedly welcome the axing of some of the bureaucratic targets we have in place now. The shift of focus on patient outcomes is also welcomed. The time and money spent chasing admin targets is enormous and completely soul destroying. I would like to see clinical targets such as time from initial presentation to confirmed diagnosis within a given period of time. What patients really want is to quickly find out what the problem is, so that any treatment needed can be started asap" – Liz Selby, Bedfordshire
"Remove barriers to quality care? Reduce bureaucracy? At last! I do believe that many of the targets currently set are either deliberately made unachievable or are of such a level that patient care would actually be compromised. It is about time that targets were based on actual qualitative issues and not just about figures. I am sure that most doctors would agree that the focus needs to be on quality care. With this in mind, we hope that commissioning through primary care will be seen as a way forward and an excellent model for the future. From what has been said so far, that would appear to be the case" – Amanda Cullum, North Lincolnshire
"Although I have not always believed that targets have ensured a better quality of care, the accountability element did help drive up some standards in primary care, ie, diagnostics, monitoring, medication reviews etc, that were less likely to be offered in some GP practices prior to targets. The taxpayer who funds the NHS should at least be entitled to a quality service that provides the level of healthcare we all expect when we need it. Are we going to to go back to the bad old days? GPs should also be subject to public financial audit to ensure appropriate use of funds from the public purse to evidence continued investment in development of patient services" – Name and address withheld