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Wales Audit - Many patients face long waits for NHS treatment in Wales

The Welsh NHS is struggling with waiting times for elective care but emerging plans to re-think services could make things better.

Our new report NHS Waiting Times for Elective Care in Wales highlights that NHS Wales' current approach "does not deliver sustainably low waiting times" but that "emerging plans have potential to improve the position if they are implemented effectively".

The report finds that while many patients are happy to wait for their treatment, a significant minority feel they wait too long. For some patients this means their condition gets worse while they are waiting to be seen. Performance against the Welsh Government’s targets has deterioriated significantly, and whilst there are some differences in the way waiting-times performance is measured, Scotland and England are doing better against more stringent targets.  

Auditor General for Wales, Huw Vaughan-Thomas said:

We are clear in our findings; the current approach to delivering services does not deliver sustainably low waiting times. As I have highlighted before, there needs to be an open and honest discussion about the way services are delivered. There are emerging plans that have the potential to improve this position, but the NHS will need to act strongly and bravely to commit to this if meaningful changes are to be achieved.

The report highlights that while a majority of patients were treated within the 26 week target in March 2014, 11 per cent of patients had waited longer than this, and 3 per cent had waited more than 36 weeks. 

It is also noted that waiting time targets have not been met since September 2010 with performance getting worse in recent years.

It concludes by stating that NHS Wales will need to ‘act on emerging ideas’ particularly prudent healthcare, to challenge and improve the overall system of planned care.

This report follows on from our publication NHS Wales: Overview of Financial and Service Performance 2013-14, which was released in October 2014. Both reports highlight and re-emphasise the need for there to be transformational changes in the way services are delivered if the NHS Wales is to meet future demand.

Key recommendations

The Welsh Government needs to work with health boards to:

  • Ensure there is a clearer plan to create sustainable and appropriate waiting times based on a realistic understanding of demand and capacity across the NHS.
  • Radically re-shape the current outpatient system to improve efficiency and focus on the needs of the patient.
  • Review the referral-to-treatment rules and the way they are interpreted locally to make sure that patients are not treated unfairly.
  • Publish more detailed national and local data to support the scrutiny and management of waiting times.
  • Ensure there is better communication with patients about their responsibilities and what to expect from the care system.

The report also includes a full technical report to go alongside the main report and its findings. 

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