Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the 2025-26 NHS Payment scheme consultation notice, whether there will be a deterioration in waiting times as a result of payment limits for elective services; and whether there will be (a) a nationally set floor for level of activity of each elective service in each ICB and (b) a minimum level of provision for ADHD and ASD assessments.

As set out in the Elective Reform Plan, integrated care boards (ICBs) will be allocated funding needed to deliver improvements to the 18-week referral-to-treatment performance standard for consultant-led care. The 2025-26 NHS Payment Scheme consultation proposes that, as a minimum, commissioners need to ensure that the planned level of activity would deliver their target referral to treatment time improvement for consultant-led treatments, considering affordability.

The consultation also proposes that commissioners have the option of breaking down the planned level of activity into specific limits set at service, specialty or procedure level. These could consider where additional activity is required and where waiting times are already within the 18-week standard. However, there would be no requirement to break the limit down in this way.

The introduction of a payment limit is being proposed to increase commissioners’ ability to manage their finite resources prioritising the specific health needs of their populations. In planning local service provision, including for attention deficit hyperactivity disorder and autism spectrum disorder assessments, ICBs should consider how local funding can be deployed to best meet the needs of their local population.