NHS to miss treatment wait targets
The National Health Service is set to fall well short of its target of ensuring that no one waits more than 18 weeks from seeing a family doctor to completion of treatment, latest official figures suggest.
But while the figures point to waits for diagnostic tests being a key contributor to delays in treatment, private sector contracts originally designed to deliver 1.5m extra tests a year are still being held up by an ever lengthening review in the Department of Health of whether they should go ahead.
Negotiations on the contracts, initially worth about £200m a year, began more than two and a half years ago. Just two are operational. A review of the six remaining schemes – which would not start operation for some months, even if they were approved today – was meant to be completed by the end of August. But a health department spokesman said at the weekend that they were still under review.
Senior health department sources insist some of the remaining deals will be approved. But private sector suppliers are doubtful that many of them will be.
Waning enthusiasm for using the contracts to boost capacity and stimulate competition come as the latest “referral-to-treatment” figures show that the NHS is running behind schedule to hit a target of no patient waiting more than 18 weeks for treatment by the end of 2008.
The figures need treating with caution as the service can currently only count the total waiting time for about 80 per cent of patients. But in January, when the figures were first collected, 47 per cent of patients completed their treatment within 18 weeks. By June that figure had risen to 54 per cent – a 7 percentage-point improvement in six months.
But with only 18 months to go, progress at the same rate would still leave 25 per cent of patients waiting more than 18 weeks. In June, 25,000 of the patients treated had waited more than a year, and almost 75,000 more than six months.
Anthony Harrison, an academic at the King’s Fund think-tank who is following the 18-week target, said: “With previous targets to cut waits for surgery there has always been an acceleration towards the end, with the figures improving faster as the deadline nears.”
“But this target is different. It cannot be achieved just by doing more of the same – more operations or more outpatient appointments. It requires changes to the way services are provided so that, for example, scans and tests can be performed and a decision made on treatment on the same day. That is organisationally much more difficult to achieve.”
From:
http://www.ft.com/cms/s/0/fda8e0b0-5f35-11dc-837c-0000779fd2ac.html
Over eighteen months ago- on January 06, 2006 Health Direct posted the following: Labour ministers promises on ambitious 18 week maximum wait for surgery when the labour government's goal to get the maximum wait for a non-emergency operation on the National Health Service down to 18 weeks by 2008 is ambitious.
The 18 week process involves moving patients through three stages. From the initial visit to the GP, the patient has to go to a first outpatient appointment, then through any diagnostic tests that are needed and finally on to the operation itself once a decision to admit has been taken.
But an analysis of Department of Health data by the Financial Times shows that the government will miss its target without additional capacity and reform of the way the service operates.
On the health department's own planning assumptions, to achieve a maximum wait of 18 weeks - from the first GP visit to an operation - the average wait will need to be about nine weeks.
That implies something like an average two week wait from GP to the outpatient visit, three weeks for diagnostic tests, which may include scans and investigative pathology, and then no more than a four week wait once a decision is made to operate.
At the moment, no data exists to measure how long that total wait is - chiefly because there are no national data on how long patients wait for diagnostics. In some parts of the country, however, patients can wait 26 weeks or longer for a scan- which would blow the 18 week promise clearly off course.
But published figures show that the average wait for an outpatient appointment is currently almost 7 weeks - more than three times longer than the two weeks that it will need to be by 2008.
That figure has been falling, down from 7.7 weeks in 2000. But it is falling so slowly that on current trends it will take 35 years to get down to an average two week wait.
"What these figures show," according to Alan Maynard, professor of health economics at the University of York, "is that of the three elements needed to get to the overall 18-week target, one is falling far too slowly, one is unknown but may well rise before it falls, and the third - the time spent on the waiting list before an operation - is actually going in the wrong direction.
"Unless something changes radically, the government is going to miss its target".
To hit it will require "an unprecedented increase in productivity", he said, when, on most measures, NHS productivity has been falling as large parts of the extra spending have gone into pay.
As these Sept 07 figures show- a quarter of the population are going to have to wait at least 18 weeks for treatment by 2009.
But while the figures point to waits for diagnostic tests being a key contributor to delays in treatment, private sector contracts originally designed to deliver 1.5m extra tests a year are still being held up by an ever lengthening review in the Department of Health of whether they should go ahead.
Negotiations on the contracts, initially worth about £200m a year, began more than two and a half years ago. Just two are operational. A review of the six remaining schemes – which would not start operation for some months, even if they were approved today – was meant to be completed by the end of August. But a health department spokesman said at the weekend that they were still under review.
Senior health department sources insist some of the remaining deals will be approved. But private sector suppliers are doubtful that many of them will be.
Waning enthusiasm for using the contracts to boost capacity and stimulate competition come as the latest “referral-to-treatment” figures show that the NHS is running behind schedule to hit a target of no patient waiting more than 18 weeks for treatment by the end of 2008.
The figures need treating with caution as the service can currently only count the total waiting time for about 80 per cent of patients. But in January, when the figures were first collected, 47 per cent of patients completed their treatment within 18 weeks. By June that figure had risen to 54 per cent – a 7 percentage-point improvement in six months.
But with only 18 months to go, progress at the same rate would still leave 25 per cent of patients waiting more than 18 weeks. In June, 25,000 of the patients treated had waited more than a year, and almost 75,000 more than six months.
Anthony Harrison, an academic at the King’s Fund think-tank who is following the 18-week target, said: “With previous targets to cut waits for surgery there has always been an acceleration towards the end, with the figures improving faster as the deadline nears.”
“But this target is different. It cannot be achieved just by doing more of the same – more operations or more outpatient appointments. It requires changes to the way services are provided so that, for example, scans and tests can be performed and a decision made on treatment on the same day. That is organisationally much more difficult to achieve.”
From:
http://www.ft.com/cms/s/0/fda8e0b0-5f35-11dc-837c-0000779fd2ac.html
Over eighteen months ago- on January 06, 2006 Health Direct posted the following: Labour ministers promises on ambitious 18 week maximum wait for surgery when the labour government's goal to get the maximum wait for a non-emergency operation on the National Health Service down to 18 weeks by 2008 is ambitious.
The 18 week process involves moving patients through three stages. From the initial visit to the GP, the patient has to go to a first outpatient appointment, then through any diagnostic tests that are needed and finally on to the operation itself once a decision to admit has been taken.
But an analysis of Department of Health data by the Financial Times shows that the government will miss its target without additional capacity and reform of the way the service operates.
On the health department's own planning assumptions, to achieve a maximum wait of 18 weeks - from the first GP visit to an operation - the average wait will need to be about nine weeks.
That implies something like an average two week wait from GP to the outpatient visit, three weeks for diagnostic tests, which may include scans and investigative pathology, and then no more than a four week wait once a decision is made to operate.
At the moment, no data exists to measure how long that total wait is - chiefly because there are no national data on how long patients wait for diagnostics. In some parts of the country, however, patients can wait 26 weeks or longer for a scan- which would blow the 18 week promise clearly off course.
But published figures show that the average wait for an outpatient appointment is currently almost 7 weeks - more than three times longer than the two weeks that it will need to be by 2008.
That figure has been falling, down from 7.7 weeks in 2000. But it is falling so slowly that on current trends it will take 35 years to get down to an average two week wait.
"What these figures show," according to Alan Maynard, professor of health economics at the University of York, "is that of the three elements needed to get to the overall 18-week target, one is falling far too slowly, one is unknown but may well rise before it falls, and the third - the time spent on the waiting list before an operation - is actually going in the wrong direction.
"Unless something changes radically, the government is going to miss its target".
To hit it will require "an unprecedented increase in productivity", he said, when, on most measures, NHS productivity has been falling as large parts of the extra spending have gone into pay.
As these Sept 07 figures show- a quarter of the population are going to have to wait at least 18 weeks for treatment by 2009.
Labels: 18 weeks, labour-liars, NHS fiasco, nhs waiting times
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