NHS App upgrade to give patients more choice over treatment

Plans for an upgraded NHS App to allow more patients in England to book treatments and appointments will be part of a package of measures unveiled by the government on Monday.

The changes will allow patients who need non-emergency elective treatment to choose from a range of providers, including those in the private sector.

But the British Medical Association (BMA) said there was a risk the policy would "discriminate or alienate" patients who did not have access to digital technology.

Health Secretary Wes Streeting told the BBC on Sunday: "The NHS needs investment, but it also needs reform, otherwise we will not break this cycle of annual winter crises."

The plan will set out how the government intends to meet one of its key election pledges - for more than nine in 10 patients to have their treatment or be signed off within 18 weeks of a referral by the end of this parliament.

Currently fewer than six in 10 are dealt with in that time. The aim will be to reduce significantly the overall waiting list which stands at just under 7.5 million.

"That's why we're setting out the specific steps - not just the investment, but the reform to make the NHS easier and more convenient to use, to give patients more choice, to get rid of the waste and inefficiency we see in the NHS," Streeting said on BBC One's Sunday with Laura Kuenssberg.

Announcing the plan, he said the move would shift the NHS "into the digital age" and help cut waiting times "from 18 months to 18 weeks".

The app would "put patients in the driving seat and treat them on time", and they would be "put in control of their own healthcare", the health secretary said.

Action will also be taken to tackle missed appointments, which can be costly for the health service, including an artificial intelligence pilot to help pinpoint patients that may need extra help to attend.

The Department of Health said the NHS app would allow more patients needing non-urgent treatment to view and manage appointments.

The first step of the plan will come into force in March, when patients at more than 85% of acute trusts will be able to view their appointments on the NHS app.

Reminders would be sent out by hospitals to reduce the number of appointments missed.

"You book a table in a restaurant these days - or even an appointment at the hairdresser - you'll get a text message 24 or 48 hours in advance to remind you. Why doesn't the NHS do this?" Streeting said.

Diagnostic tests could be booked at specialist centres with the results coming through more quickly.

Patients will also be able to contact their healthcare provider and receive regular updates, including how long they are likely to wait.

They already have the right to choose where they would like their treatment, including in the private sector, but are not always told that. Details of NHS and independent providers will be made clearer through the app.

Some of these features are already available on the NHS app and a website Manage Your Referral. But officials say just 8% of bookings are made through these platforms.

Other plans include expanding a scheme for GPs to discuss some cases with  hospital specialists before making referrals to ensure patients are treated in the right setting.

The current Advice and Guidance Scheme has resulted in 50% of cases being directed to more appropriate care rather than being put on long waiting lists and so reducing pressure on hospitals. These include some ear, nose and throat conditions.

GPs will also be able to refer patients with certain conditions directly for tests or scans without the need to see a consultant first. The aim is to reduce waiting times and remove those who are given the all clear from waiting lists.

Amanda Pritchard, chief executive of NHS England, said using technology would revolutionise access to healthcare and put "patients in the driving seat of elective care".

But the chairman of the BMA council, Professor Phil Banfield, said the focus should be on patients most in need rather than a "wasteful obsession" with artificial targets.

He said there was a danger patients without access to tablets and smartphones would be alienated.

"We already have a two-tier health system - those who can and cannot pay to access care," he said. "We must guard against creating a third tier of the disenfranchised vulnerable".

Tim Mitchell, President of the Royal College of Surgeons of England, said a new plan for reducing waiting times would be very welcome. But he added the government would fall short of its target without further reform and investment "including upgrading IT and crumbling NHS facilities".

The general secretary of the Royal College of Nursing Prof Nicola Ranger welcomed the government's trying to tackle the challenges within the NHS.

But she added: "If you want to have better care you have got to have people to look after them.

"The biggest workforce that is having the biggest challenge is nursing. We still have got 13,000 nursing vacancies in England alone; 131,000 vacancies in social care and actually nursing in this country is in a crisis."

Former Labour Health Secretary Alan Johnson said the NHS "needs a new stream of money from somewhere".

"Don't say we need to sort out adult social care and then knock down every proposal that meaningfully looks to address it," he added.