NHSE rows back on patient diversion target

TL;DR

NHSE Retracts Target: NHS England has rowed back on a widely understood new target for diverting patients from waiting lists.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)
Rationing Accusations: The move followed claims that the target amounted to rationing patient care.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)
Waiting List Pressure: It highlights ongoing efforts and backlash over reducing NHS elective waiting lists through referral diversion.[[2]](https://www.hsj.co.uk/quality-and-performance/nhse-bid-to-divert-referrals-falling-well-short-of-target/7041180.article)

The story at a glance

NHS England (NHSE) has retreated from a target seen as requiring a specific proportion of patients to be diverted from hospital waiting lists via GP referrals for specialist advice. This came after criticism that it rationed care. The article by James Illman and Caitlin Tilley in the Health Service Journal reports the development amid broader NHS pushes to cut elective backlogs.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)

Key points

NHSE rowed back on what was widely understood as a new target for the proportion of patients to be “diverted” from waiting lists.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)
The target related to increasing use of “advice and guidance” from specialists by GPs instead of direct referrals.[[2]](https://www.hsj.co.uk/quality-and-performance/nhse-bid-to-divert-referrals-falling-well-short-of-target/7041180.article)
Accusations arose that this approach amounted to rationing care by limiting hospital access.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)
Earlier, NHSE was on track to miss related goals for ramping up advice and guidance, described as unlikely to be a “silver bullet” for waiting lists.[[2]](https://www.hsj.co.uk/quality-and-performance/nhse-bid-to-divert-referrals-falling-well-short-of-target/7041180.article)
The policy ties into the Neighbourhood Health Framework aiming to shift care to community settings in high-volume specialties.[[3]](https://www.linkedin.com/posts/williampett_how-to-ensure-advice-and-guidance-works-activity-7448290575209873408-Tdx4)

Details and context

The target stemmed from efforts to tackle NHS elective waiting lists, which have hovered around 7 million, by encouraging GPs to seek specialist “advice and guidance” before referring patients. This pays GPs £20 per case and aims to avoid unnecessary hospital appointments, with past data showing over 1 million diversions in a period.[[4]](https://www.england.nhs.uk/2025/07/nhs-delivers-record-numbers-of-treatments-as-waiting-list-drops-to-26-month-low)

Critics, including in outlets like The Telegraph, called similar mandates rationing, especially with aims like 25% referral cuts in some areas or diverting one in four patients by 2027.[[5]](https://uk.news.yahoo.com/arbitrary-targets-won-t-save-200000381.html)[[6]](https://www.telegraph.co.uk/news/2026/03/29/nhs-rations-hospital-appointments-to-cut-waiting-list)

NHSE had set ambitions in frameworks like Neighbourhood Health for 25% diversions in 10 specialties by March 2027, but performance fell short, prompting the row-back reported on 22 April 2026.[[2]](https://www.hsj.co.uk/quality-and-performance/nhse-bid-to-divert-referrals-falling-well-short-of-target/7041180.article)

Key quotes

None reliably sourced from the article.

Why it matters

The retreat underscores tensions in NHS elective recovery, where diversion policies seek efficiency but risk access barriers amid high demand. For patients and GPs, it means less pressure for mandatory advice and guidance use, potentially preserving referral options, though waiting lists remain a challenge for trusts and commissioners. Watch for updated NHSE guidance on neighbourhood plans and whether diversion rates stabilise without targets.[[2]](https://www.hsj.co.uk/quality-and-performance/nhse-bid-to-divert-referrals-falling-well-short-of-target/7041180.article)

What changed

(1) A new target was widely understood as requiring a specific proportion of patients to be diverted from waiting lists via advice and guidance. (2) NHSE has now rowed back on it following rationing accusations. (3) Reported 22 April 2026.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)

FAQ

Q: What was the controversial NHSE target about?

A: It was widely understood as a new goal for a specific proportion of patients to be diverted from hospital waiting lists, mainly through GPs using specialist advice and guidance instead of referrals. This aimed to cut elective backlogs but drew rationing claims.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)

Q: Why did NHSE row back on the target?

A: The retreat followed accusations that the policy rationed care by limiting patient access to hospital treatment. It responded to widespread understanding and backlash against the approach.[[1]](https://www.hsj.co.uk/news/nhse-rows-back-on-controversial-target/7041561.article)

Q: How does patient diversion work in this context?

A: GPs seek “advice and guidance” from specialists, paid £20 per case, to manage patients in community settings rather than adding them to hospital lists. Past efforts diverted over 1 million patients in a year.[[4]](https://www.england.nhs.uk/2025/07/nhs-delivers-record-numbers-of-treatments-as-waiting-list-drops-to-26-month-low)

Q: What is the link to neighbourhood health plans?

A: The target tied into the Neighbourhood Health Framework, pushing 25% diversions in high-volume specialties by March 2027 to shift care locally.[[3]](https://www.linkedin.com/posts/williampett_how-to-ensure-advice-and-guidance-works-activity-7448290575209873408-Tdx4)