Slow progress on hospital waiting lists
pharmafile | November 9, 2007 | News story | |Â Â Â
A key target to cut waiting times for operations looks unlikely to be hit by the NHS, prompting the government to massage the figures and lower its target.
Ministers say the health service is on track to have all patients who need treatment to receive it within 18 weeks of their first visit to a GP. But the reality is that progress in many parts of the service is too slow to hit the government's December 2008 deadline.
The government has some good news to report – for patients who don't need to be treated in hospitals, more than three quarters (76%) of non-admission patients are now treated within 18 weeks of their first visit to the GP.
But cutting hospital admission waiting times is proving much more difficult, with just 56%, currently seen within the timeframe. The figure represents an 8% increase since March – a substantial improvement, but too slow to help the NHS reach 100% in just over 12 months time.
If this rate of improvement were to continue in 2008, the figure would only reach 80% for hospital admissions, significantly short of the total.
Despite the underlying statistics, the government claims it is still 'on course' to hit the target by December next year.
Health Minister Ben Bradshaw said: "Ten years ago it was common for people to wait 18 months for an operation. Since then, the NHS has come a long way and it is making good progress towards effectively ending waiting next year."
He concluded: "Some places are making progress faster than others, but I'm confident that by the end of 2008, patients can expect to start their treatment within a maximum of 18 weeks from GP referral to treatment."
Foreseeing failure to hit the target, the government has used a number of tactics to soften the blow. The first is separating out non-admission figures from admission figures, and has focused on the high figure of the former (76%), rather than the lower rate for patients being admitted to hospital.
Bradshaw has also announced that the target may be lowered to 90%, allowing for 10% of patients to wait longer where it is 'clinically justified'.
Examples of this would be where a patient needs to lose weight before having an operation, or where it is convenient to have the procedure later.
The proposed lowering of targets has already proved popular with surgeons' representatives. Dr Jonathan Fielden, chairman of the BMA's Consultants Committee, said the 90% target would help shift the focus towards quality and ease the pressure on the service.
Orthopaedics struggling
Not surprisingly, the figures reveal that some regions of the NHS are nearer to hitting the target than others, and some specialists are cutting their waiting list faster than others.
Heart of Birmingham teaching PCT has one of the best rates for the completion of all operations within 18 weeks, with over 80% of patients treated, while just one in three patients in the Hull PCT area are currently treated this quickly.
Meanwhile across the NHS, gastroenterologists are on average treating 82% of patients in time, whereas just 33% of patients waiting for trauma or orthopaedic surgery have their operation within 18 weeks of first visiting a GP.
Nigel Edwards, director of policy at the NHS Confederation, said earlier this year there was optimism in the health service that the 18-week target could be achieved.
But he added: "We must not forget that this is probably the most challenging target that the health service has been asked to take on. Meeting the target will require many NHS trusts to completely redesign how patients flow through the system."
Responding to the government's changes, Norman Lamb, the Liberal Democrats' spokesman on health, said: "Ministers will struggle to convince a public already sceptical about government statistics that this change isn't merely providing political cover because of fears they will fail to achieve their target.
"It must have been clear from the start that the 18 weeks target wouldn't be suitable for everyone, including those who want to delay their treatment for a clinical or other reason. This seems like yet more shifting sands over waiting times. Why is this key target being changed now? Many people will smell a rat.
"Giving every patient an entitlement to high quality care would deliver more improvements in the NHS than a centrally-imposed bureaucratic target."
