18-week target looks unobtainable

James Gubb, 22 June 2007

A new online briefing released today by Civitas looks in detail at statistics relating to government performance on waiting times, in particular those recently released on the 18-week referral to treatment target. It argues that a number of statistics hidden in the data suggest the NHS has a massive, and probably insurmountable, challenge to meet the 18-week RTT target by 2008 without compromising patient care. In particular that:
– A substantial number of patients are still waiting significantly longer than 18 weeks;
36% are waiting beyond 26 weeks and 12% are waiting beyond a year.
– There are real variations in the time waited by patients both geographically and across medical specialities. For example, just 25% of orthopaedic patients are seen within 18 weeks, compared with 79% of those receiving thoracic medicine; and just 33% of patients in the South East Coast SHA are treated within the target compared with 60% in the East Midlands SHA. It will be incredibly difficult for those with low proportions of patients treated within the target to turn this around in little over a year.
-The NHS remains some way off meeting the goal that patients receive all diagnostics within 13 weeks of their first outpatient appointment, which will have to be considerably less if the 18-week pathway is to be met. 109,694 people were still waiting beyond 13 weeks as of March 2007.
Moreover, despite the improvements in cutting waiting times for inpatient and outpatient appointments, median waiting times have actually increased and 700,000 people are still on waiting lists for inpatient treatment with over 950,000 waiting for an outpatient appointment.
And NHS patients are still waiting much longer than those in other health systems. According to surveys conducted in 2005 and 2006 by the Commonwealth Fund merely 6% of primary care physicians in the UK thought their patients ‘rarely or never experience long waiting times for diagnostic tests’, compared with 76% in Germany; and 41% of respondents in the UK reported waiting longer than 4 months for elective surgery, compared with just 6% in Germany and 8% in the US.