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NHS Confederation - Closer working across NHS key to reducing elective care waiting times

Seeing and treating patients within 18 weeks hinges on commissioners and providers working closely together across the whole system to 'drive down' waiting times, the NHS Confederation said yesterday (23 January).

The remarks come in response to a new National Audit Office (NAO) report showing "the increasing challenge of sustaining the 18-week waiting time standard for elective care."  

Standards met nationally

NHS waiting times for elective care in England reports an increase in the number of people each month waiting longer than 18 weeks without treatment – 169,000 by the end of October 2013, compared with 138,000 at the same point in 2012 – but states that nationally, waiting time standards have been achieved, despite breaches by some trusts.

Referral to treatment

“The 90 per cent referral to treatment (RTT) standard has been achieved on all but two months since August 2008," the Confederation's chief operating officer, Matt Tee, highlighted. 

"The RTT target looks at a whole-system experience –  it's not just about treatment in a hospital, it includes diagnosis, decision to treat, access and other elements – so it is important that no single part of the health service is celebrated or vilified for it being achieved or missed."

'Inconsistencies'

But the report identifies inconsistencies in the way trusts measure waiting times and errors in the waiting time recorded, as well as mis-recorded referral to treatment times data.

The NAO also found that NHS England does not have sufficient assurance about how trusts are performing. It said the organisation's system of checks should spot some errors and inconsistencies and discrepancies, but will not detect the kind of errors identified by the National Audit Office without independent validation of trusts’ data. 

Recommendations

The report makes several recommendations to improve the recording and reporting of waiting times data, which would see closer working between commissioners and providers. The recommendations include:

  • NHS England should consider whether greater consistency, accuracy and usefulness would be achieved if waiting times were recorded and reported in the same way by all trusts.
  • NHS England should make sure that there are sufficient and reliable mechanisms in place to encourage trusts to meet waiting time standards, including effective financial incentives.
  • Clinical commissioning groups (CCGs) and trusts should work with referral management centres to ensure clock start dates are correctly recorded and passed on to trusts with supporting documentation.
  • CCGs and trusts should work together to impress on patients their rights and responsibilities.
  • Trusts and CCGs should encourage patients to take ownership of their pathway to treatment by ensuring that each trust access policy is up to date, patient friendly and publicly available.

Find out more

Access the report from the National Audit Office's website

Read the NHS Confederation's media statement.

Facing the Future...find out more