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A journalist’s guide to the 18-week waiting times data

by Rob Findlay

Every month, the Department of Health publishes 18-week waiting times data for England. The publication timetable is here (look for “Referral to treatment waiting times statistics”), and the data itself is published here. This is a quick guide to help journalists find their way around the data.

As the term “referral to treatment” (or “RTT”) suggests, a patient’s waiting time “clock” starts ticking when the patient is referred by their GP to a consultant (it doesn’t apply to referrals to non-consultants such as physiotherapists). For as long as the clock is still ticking, their clinical pathway is called “incomplete”. The clock only stops ticking when the patient starts receiving definitive treatment (or when it’s agreed that they shouldn’t be treated). The detailed rules for all this are found under “Methodology, Rules and FAQ” on the main statistics page.

The waiting times statistics page has lots of different data on it, so it’s worth understanding what the different kinds are.

  • If you want total figures for the whole of England, then use Commissioner Data. When you’ve downloaded and opened a spreadsheet, click the worksheet called “National” and look for a row near the bottom of the table where, in the Treatment Function column, it says “Total”; that’s the all-specialties data.
  • If you want detail for individual NHS Trusts, then use the Provider Data. When you’ve downloaded and opened a spreadsheet, click the Provider worksheet to get the detail.

All these spreadsheets are large, and contain lots of hidden columns that you will want to reveal by clicking the + symbol in the grey area just above the table. Then you’ll need to freeze the headers so that you don’t lose your place when scrolling around in the spreadsheet: click on the first actual number in the table (just under the header “>0-1”) and select Freeze Panes from the Window menu (more on Freeze Panes here). Now you can scroll around more easily, or if you’re looking for Trusts you can search for them by name using Find in Excel (more on Find here).

One other technical point: when you open one of these spreadsheets, Excel might ask if you want Macros enabled, or cells updated from another spreadsheet. Just say no.

What’s the difference between Adjusted Admitted Pathways, Incomplete Pathways, and so on? Each spreadsheet contains a Glossary sheet with all the definitions, but here’s a quick run-down:

  • Incomplete pathways are what everybody used to call “The Waiting List”. This is the most important data of all. These patients may have been seen in clinic by a hospital doctor, and they may even have had a load of diagnostic tests, or none of those things may have happened; the important thing is they haven’t yet started definitive treatment (or been discharged) and so they have an “incomplete pathway”. The data shows how long these people have waited so far, up to the end of the month that the data relates to.
  • Adjusted Admitted Pathways are what most people usually focus on (wrongly, in my view). These are patients who started receiving treatment during the month as an inpatient or day case (but not outpatient). The data shows how long they waited before their treatment began. The word “Adjusted” means that if a patient says they don’t want their treatment just yet (for instance, a teacher might want to wait for the school holidays before having an operation), then the delay they asked for is deducted from their waiting time.
  • Admitted Pathways are the same as the Adjusted Admitted Pathways, except that no time is deducted when patients ask for a delay.
  • Non Admitted Pathways are patients who started treatment during the month as outpatients, plus those patients who decided not to be treated (which includes “watchful waiting” to see if the condition gets worse).

We provide detailed commentary on each month’s RTT waiting times data, usually on the same day it is released. Our report appears first on HSJ blogs here, and then a few days later on our open blog site here.

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