The NHS should abolish many of its national targets while shifting its focus towards preventive healthcare, according to a review by a former Labour health secretary.
The study by Patricia Hewitt, commissioned by the government and due to be published on Tuesday, will say that, while targets can help concentrate the minds of those responsible for a service, having too many makes them less effective.
It comes at a time when record numbers of people are on NHS waiting lists and as the health service in England continues to miss targets on A&E waits, the speed of ambulance responses, and cancer treatment times.
The review, extracts of which have been seen by the PA news agency, will say that setting new targets and failing to provide adequate funding for new initiatives makes it far harder to plan new services and recruit staff.
It will add that an excessive focus on hitting targets by managers can lead to “gaming” of the targets and a “disastrous neglect of patients themselves”.
Figures show that, in February, only 71.5% of patients in all A&E departments were seen within four hours. The last time the 95% target was met was in July 2015.
An investigation by the Guardian found that more than 500 seriously ill patients died last year after ambulances took up to 15 hours to reach them.
Reports in December suggested the government was planning to scrap most national targets in favour of a greater emphasis on local management after the initial findings of Hewitt’s study.
The study will recommend the current targets be replaced by no more than 10 national priorities and that local leaders be given more space and time to deliver improvements in services.
Hewitt will also say that hospitals will never be large or efficient enough to cope with the demands placed on them by an ageing and increasingly unhealthy population.
She will call for a “shift upstream” intended to avoid people going into hospital in the first place and for the share of total NHS budgets going towards preventive care to be increased by at least 1% over the next five years.
She will say the government should consider creating citizen health accounts to hold people’s health data and help them manage their own health and care.
Hewitt served as health secretary from 2005 to 2007 and was thought of as a modernising member of the New Labour government.