Press Release - Inpatient and outpatient waiting in the
NHS
26 July 2001
The need for wider implementation of good practice to manage and
reduce waiting lists and times in the NHS in England is highlighted
today in a National Audit Office report. In March 2001 some 42,000
patients had been waiting more than 12 months for admission to
hospital, and there are large inequalities across the country in
the time that people have to wait for treatment. The Department of
Health should consider whether underpinning systems for counting
who is on the list and how long they have waited need to be
improved.
The report, presented to Parliament by NAO head Sir John Bourn,
identifies a number of areas where the Department of Health and NHS
trusts have taken positive steps to reduce waiting lists and
waiting times, but argues that further changes could be made. The
Department announced (13 June 2001) that, building on the reduction
in waiting lists, the Government and the NHS would now move on to
cut waiting times for treatment.
Key findings in the report are:
- The Department is making concerted efforts to reduce
waiting lists and lists have reduced. Measures include
additional funding, publication of "Your Guide to the NHS", the
publication of guidance and best practice and the use of teams that
visit trusts to identify solutions to waiting list issues.
- Waiting lists and times are too long for some
patients. Although inpatient and outpatient waiting lists
have reduced simultaneously over the last two years, at 31 March
2001 246,000 people had been waiting for admission to hospital for
longer than 6 months and, of these, 42,000 had been on the list for
more than 12 months.
- There are significant variations across the
country. There are large inequalities across the country
in the number of people who have to wait longer than six months for
admission to hospital.
- Some patients are being treated in a different order to
their clinical priority in order to meet targets. For
practical reasons there needs to be some flexibility in the order
in which patients are treated but the Department have emphasised
that it is inappropriate to operate on routine patients in
preference to those who require more urgent treatment solely to
meet waiting list targets. Twenty per cent of consultants whom the
NAO surveyed said, however, that, in 1999-2000, they frequently
treated patients in a different order to their clinical priority in
order to reduce their waiting list or to prevent a patient waiting
longer than 18 months.
- There are misconceptions about what is counted on
waiting lists and currently the total time a patient waits (other
than for cancer treatment) from being accepted on an outpatient
list to being treated is not calculated or monitored.
Inherent problems in the systems and procedures mean that the NAO
cannot give an assurance about the complete accuracy of NHS waiting
lists. In practice numbers at any one time are likely to be
overstated because they include people who should have been removed
from the list.
- Wider implementation of innovative practices would make
a significant contribution to reducing waiting lists and
times. The report identifies five key areas of good
practice: the way GPs refer patients to hospital; the operation of
clinics at optimal capacity, optimisation of the use of operating
theatres, improvement in discharge arrangements; and management of
the process as a whole. The National Patients’ Access Team has a
comprehensive range of work programmes in place and are taking
these forward.
Key recommendations are as follows.
- Management of waiting lists. The Department of
Health should consider whether trusts should monitor and manage the
total time patients wait, and conduct research into why different
health authorities have different waiting times. In addition, the
Department should review options for keeping patients better
informed regarding the times that they can expect to wait.
- Accuracy of waiting lists. NHS trusts should
validate waiting lists at least every six months, and they should
be given guidance and advice to resolve inconsistencies regarding
the treatments and categories of patients to be included on waiting
lists.
Sir John said today:
" The NHS have taken positive steps to reduce waiting lists
and the NHS Plan sets out challenging targets for reductions in
waiting times by 2005. There is much yet to do and we have
identified innovative practices in key areas which, if implemented
across the board, will make a big contribution towards achieving
the waiting time target."
Notes for Editors
Press notices and reports are available from the date of
publication on the NAO website at http://www.nao.org.uk/ Hard copies can
be obtained from The Stationery Office on 0845 702 3474.
The Comptroller and Auditor General, Sir John Bourn, is the head
of the National Audit Office employing some 750 staff. He and the
NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 40/01
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