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Inappropriate adjustments to NHS waiting Lists

The National Audit Office has published the results of its examination into the inappropriate adjustment of waiting lists at a number of NHS trusts.

In July of this year the NAO published its report Inpatient and outpatient waiting in the NHS looking at the accuracy and management of NHS waiting lists. In that report it listed six NHS trusts where waiting lists had been inappropriately adjusted and promised further work on them. Today’s report sets out the results of that examination which takes account of a further three trusts where inappropriate adjustments have come to light.

A number of recommendations are made by the NAO in the light of these findings.

The Department of Health should seek assurances from the Chief Executive of each NHS trust that there have been no inappropriate adjustments to waiting lists. They should investigate in more detail those trusts where more than 10 per cent of patients are suspended and which have more than 2 per cent of patients waiting more than twelve months for treatment. There are some 13 trusts which currently meet both these criteria.

The Department of Health should issue clear guidance on the actions and procedures to be followed by trusts, including disciplinary action, where waiting list or other irregularities are discovered.

As part of the guidance the Department of Health should take steps to ensure that trusts carry out effective enquiries into alleged irregularities, sufficient to ensure that they can be used as a basis for determining whether to take disciplinary action against individuals concerned. The enquiry team should be independent, external and sufficiently resourced to enable a thorough review to be undertaken within a reasonable timeframe.

The Department of Health should re-issue and strengthen instructions to ensure that trusts do not use confidentiality clauses in compromise agreements; and that such agreements include provision for clawback of compensation in the event of re-employment within the NHS.

The Department of Health should remind NHS bodies of the need to provide each other with a full knowledge of the employment history of staff seeking employment.

Notes for Editors

The nine NHS trusts where inappropriate adjustments have come to light are: Barts and the London; Guy’s and St Thomas’; Plymouth General; Redbridge Health Care; Salford Royal; South Warwickshire General; Stoke Mandeville; Surrey and Sussex Healthcare; and University College London.

Press notices and reports are available from the date of publication on the NAO website at 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.

PN: 60/01