What NHS trusts need to deliver in 2017/18 is set out in the 2017/19 NHS planning guidance. The requirement is best summarised in the form of the key provider sector elements of the “nine must-dos for 2017-19” from the planning guidance. These must all be delivered while absorbing cost and demand pressures of 2.1% and 3.1% respectively – totalling 5.2%:


  • Four-hour A&E standard – 95% of patients should be seen, treated or discharged within four hours
  • 18-week elective surgery standard – 92% of patients should wait no longer than 18 weeks for non-urgent consultant led treatment

New taskforce report implementation

  • Implement the independent cancer taskforce, which resulted in the cancer strategy implementation plan
  • Implement the Five year forward view for mental health including increasing baseline spend on mental health to meet the mental health investment standard


  • Provider sector in financial balance


  • Implement agreed sustainability and transformation plan (STP) milestones, though we have excluded this element in our analysis as these milestones have not been agreed and do not, at this stage, represent 2017/18 operational delivery tasks.

While individual trusts may be able to meet all their delivery requirements, and individual requirements can be met at a sector level, the 2017/18 provider sector task is currently undeliverable in aggregate. To demonstrate this, chapter 4 analyses each individual element, the extra cost required to deliver it in 2017/18 and then compares this to increased funding levels for the year ahead. We set out in chapter 6 how the NHS could ensure the task is more deliverable.