Spending Review 2002: Public Service Agreements

The 2002 spending review was completed on 15 July 2002. The government's public service agreements were reissued, containing three objectives:

• improving service standards
• improving health and social care outcomes for everyone
• improving value for money.

The 1998 targets for health had focused on mortality and cancer referral times. The 2002 targets still focused on longer-term outcomes, but also focused greatly on reducing waiting times and increasing access. The main targets for improving service standards were to:

• reduce the maximum wait for an outpatient appointment to 3 months and the maximum wait for inpatient treatment to 6 months by the end of 2005
• reduce the maximum waiting time for inpatient and day case waiting time to 3 months by 2008
• reduce the maximum A&E wait to 4 hours by the end of 2004
• guarantee access to a primary care professional within 24 hours and a primary care doctor within 47 hours from 2004
• ensure that, by the end of 2005, every hospital appointment could be booked for the convenience of the patient
• secure improvements in independent, national surveys of patient experience
• increase the number of people supported to live at home to 30% of the total being supported by social services.

The second objective (improving health and social care outcomes) focused on:

• reducing mortality rates for heart disease patients by at least 40% in people under 75, and, for cancer, by at least 20% in people under 75 by 2010
• improving life outcomes of people with mental health problems and reducing the figures for suicide and undetermined injury by at least 20% by 2010
• reducing the teenage (under 18 years) pregnancy rate by 50% by 2010
• reducing inequalities in health outcomes by 10%, using infant mortality and life expectancy at birth as measures.

PSAs for 2005–08

In July 2004, the Treasury again published new PSAs (for 2005–08) as part of the 2004 Spending Review.The PSAs highlighted the need to maintain performance against targets such as the 18-week wait from referral to treatment and the 4-hour accident and emergency target.

In addition to targets to reduce overall mortality, there was a focus on public health-related indicators such as smoking rates and obesity.

Following the 2007 comprehensive spending review, PSAs became less target-based and instead outlined the highest objectives for government.