The upside-down reporting of NHS waiting times

by Rob Findlay

Waiting lists grew 61% in the past year

said the Guardian, reporting that “11,857 people in June had waited half a year to receive treatment, up from 7,360 in June 2010”.

Waiting times continue to soar

said the Mirror, reporting that “The number of people on treatment lists for more than 18 weeks increased by 9,013 to 31,483 in the 12 months to June”.

NHS waiting lists rise

said the opposition Labour Party, adding that “Compared with last year, a third more patients are waiting longer than 18 weeks for hospital treatment and the situation is getting worse by the month. With the figures also showing a doubling since May 2010 in the number of patients waiting over a year for treatment, it is clear that people can’t trust David Cameron to keep his NHS promises.”

Which is all rather different from my assessment: “Waiting times steady in June” (which admittedly is not a very exciting headline). We’re all working off the same data release, so why the different messages?

The explanation is simple. I was looking at patients still waiting at the end of June (the so-called “incomplete pathways”), and they were looking at patients who got treated during June (specifically, the so-called “adjusted admitted pathways”). The result: good gets reported as bad.

Let’s take the Guardian’s numbers first. They are working off the data in this spreadsheet, and 11,857 is the number of patients admitted during June 2011 who had waited more than 26 weeks (on an adjusted basis, as with all the other admission-based figures I will quote here). They are comparing this with the number admitted in June 2010 who had waited more than 26 weeks, which was indeed 7,360.

Yes, it’s an increase of 61 per cent. But an increase in what? Not in the waiting list: that shrank slightly from 2,569,098 to 2,551,779 (as you can see from DH’s “incomplete pathways” data in this spreadsheet). Not even in the number of over-six-month waiters on the waiting list: that fell from 95,814 in June 2010 to 93,123 in June 2011.

No, the increase of 61 per cent was in the number of over-26-week waiters being admitted for treatment. But treating long-waiters is a good thing, right? It’s certainly better than the alternative: not treating them, and leaving them to wait even longer. So when the NHS treats long-waiting patients, this is somehow being reported as a disaster.

This is all starting to look topsy-turvy.

Moving on the Mirror, you can probably guess where they got their figures from. That’s right: 31,483 is the number of patients admitted during June 2011 who had waited more than 18 weeks (on an adjusted basis), taken from the same DH spreadsheet the Guardian were using. This was an increase of 9,043 (not quite the figure the Mirror worked out) from 22,440 in June 2010.

Again the Mirror are reporting an increase in the number of long-waiters being treated, not an increase in those still waiting. In fact the number of over-18-week waiters on the waiting list did go up, slightly, from 221,588 to 226,466 (an increase of 2.2 per cent). But that isn’t what they reported.

Moving on to Labour, we have already covered their first statistic, which is the same one used by the Mirror. Their second (“a doubling since May 2010 in the number of patients waiting over a year for treatment”) is, yet again, based on an increase in the number of over-52-week waiters who were admitted during June (from 430 in June 2010 to 718 in June 2011; an increase of 67 per cent, rather than a doubling). Again, surely it is a good thing if the NHS treats its longest-waiting patients?

If they had looked at patients who were still waiting, what would they have seen? The number of over-52-week waiters on the waiting list fell from 18,221 in June 2010 to 13,259 in June 2011, an improvement of 27 per cent. (In fact the June 2011 figure would have been the best ever recorded in the NHS, if Kingston Hospital had not ended its absence from the data series by landing 2,314 over-52-week waiters onto the national waiting list.)

Good is reported as bad, improvements as disasters, and then when patients are kept waiting the headlines fall silent; all because people are watching the wrong numbers. I think this is a cause for shame, and I’ll be coming back to this theme in future posts.

This post first appeared at HSJ blogs.
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