“The NHS is often viewed as a single organisation when it is not – the NHS is in fact a complex system. The Nuffield Trust is absolutely right to highlight that target delivery and performance reflects system issues and that system solutions are needed.
“Our members tell us the whole system is under more pressure than ever. Tackling this requires commissioners and providers to work together across the whole system to help drive down waiting times. They will do this by working to change the way care is delivered. They will need support to make this a reality. “These findings have come at a crucial time. We know the pressures across the system make it harder for NHS organisations to meet their national targets. We also know waiting for operations and cancellations for patients can be distressing. It’s a credit to the NHS that it is performing so well in the face of rising demand for care, significant extra activity and flat funding. “We need to ensure that the debate around health and care focuses on how we can address fundamental challenges – this means changing models of care so they better meet the health needs of people as set out in the 2015 Challenge, supported by NHS England in the Five Year Forward View.”