• The threshold for trusts to access the elective recovery fund has been altered, from 85% of 2019/20 activity levels to 95%.
• The change was set out in a letter sent on Friday to local leaders from NHS England and NHS Improvement.
• It also said the position on the longest waits must be recovered more rapidly.

Commenting on the elective recovery fund, the chief executive of NHS Providers, Chris Hopson said:

"Thanks to the dedication of NHS staff, trusts have been going faster than expected to deal with the care backlog which has built up during the pandemic.

"It is understandable that the government wants to see progress here and that NHS England has reviewed the threshold levels which have been set to access the elective recovery fund, adjusting from 85% of 2019/20 activity levels to 95%.

"But there are definite and important risks here. We set out four points to NHS England when they were considering their new approach.

"Firstly, trust leaders are clear that activity rates will decline over summer as many staff will take annual leave, a lot of it delayed as a result of working through the pandemic.

"Secondly, some activity will have to be scaled back as COVID-19 demand rises. Some trusts are already having to cancel planned operations and are converting surgery recovery wards in order to treat to COVID-19 patients.

Funding, support and incentives are critical in dealing with the backlog.

"Thirdly, funding, support and incentives are critical in dealing with the backlog. The thresholds cannot be used as a means of 'throttling back' activity levels.

"Lastly, trusts are clear that most of the elective recovery funding will be used up in the first half of the year. More funding will be needed in the latter half to continue at full pelt.

"The new secretary of state for health and care has been clear that tackling the care backlog is an absolute priority. It is vital that he makes sure that trusts have the funding they need to do this."