But plans are only one part of the explanation for deteriorating performance. This Committee’s June 2019 report NHS waiting times for elective and cancer treatment concluded that the Department had allowed NHS England to be selective about which standards it focused on, reducing accountability. We recommended that the Department and NHSE&I clarify to the Committee how NHSE should be held accountable, a recommendation with which the government agreed.11 We heard from the Department that it did not formally change the waiting times standards when waiting times performance declined before the 4 C&AG’s Report, pages 20, 27 5 NHS0040 Royal College of Emergency Medicine submission para 2 6 NHS0003 Royal College of Radiologists submission para 3 7 NHS0004 Royal College of Pathologists submission para 2; NHS 0020 Royal College of Surgeons submission para 10 8 Q24 9 Q27 10 Q26 11 Committee of Public Accounts, NHS waiting times for elective and cancer treatment, 100th report of session 2017–19, HC 1750, para 2; HM Treasury, Treasury Minutes Progress Report, CP313, November 2020, para 2.1, page 159 10 NHS backlogs and waiting times in England pandemic but it had accepted that given the pressure in the system clinicians would focus on the clinical priorities of individual patients instead.12 We asked the Department about how it planned to hold the NHS to account for the additional funding that it is now set to receive for elective recovery. An elective recovery plan had been scheduled for publication in November 2021 but had been delayed.13 The Department told us it had so far been interrupted from focussing on elective care recovery by the Omicron wave of COVID-19 but that it accepted the need for detailed plans encompassing the necessary elements of funding, capacity, workforce, organisation and clinical decision-making.14 (The recovery plan was subsequently published in February 2022).15 The Department also explained that it would continue to set the top-level measures for t