Your 18 week waits: November 2012 data

by Rob Findlay

Here is the local picture on 18 week waits, fully updated with the October 2012 RTT waiting times data just released by the Department of Health for England.

If you want to pick a Trust, independent sector provider, or PCT, and get a full analysis of the pressures in any specialty, then all the detail is here: Gooroo reports

Because this latest data release included a lot of revisions of previous months’ data, it’s taken a bit longer than normal to do all the crunching. But all revisions have now been fully taken in, and here is the latest version of the Gooroo NHS waiting times fact checker

Where are the very-long waiters?

One-year-waiters have fallen dramatically, and the end is (perhaps) now in sight with the introduction of “zero tolerance” penalties in next financial year’s Contract. Until all the one-year-waiters are finally treated, however, they are going to carry on getting the top billing here.

It is nothing short of a disgrace that some providers are still keeping patients waiting more than a year for treatment, while nearly everybody else is being treated so quickly. Yes, in some places we’re down to the difficult ones, including some who need ITU / two surgeons / special equipment / whatever, but the NHS has made a promise to these patients and it’s time to deliver on it.

Check out the Robert Jones and Agnes Hunt Orthopaedic Hospital, for instance: they have 100 patients waiting over a year in Orthopaedics, which is a decent chunk of the 1,147 one-year-waiters across England; and yet (helped along by a lot of clock-pausing) they’re still “achieving the target” that 90 per cent of admitted patients should have waited less than 18 weeks!

The following map compares one-year waits, 18-week waits, and total waits, with the values a year before. You can click the Trust name to get a full analysis.

Provider one year waits – summary
Provider one year waits – summary

Other maps you might find useful:
All specialties together, by NHS/IS provider (same as map above)
Each specialty separately, by NHS/IS provider
All specialties together, by PCT (i.e. population basis)
Each specialty separately, by PCT

The 92 per cent target

The most meaningful of the 18 week targets is that 92 per cent of the waiting list (‘incomplete pathways’) must be within 18 weeks. So this map series shows how long 92 per cent of the waiting list has actually waited.

92 per cent waiting times map
92 per cent waiting times map

Each specialty separately, by NHS/IS provider
Each specialty separately, by PCT (population basis)

Where are the most ‘clock pauses’?

This map shows where the greatest amount of clock-pausing is happening, measured by the difference between 90th centile adjusted and unadjusted waiting times.

Why this focus on clock pauses? Because the best way to tackle long waits in the NHS is to address the two root causes: waiting lists that are too big, and sub-optimal patient scheduling. If services come to rely on clock pauses to achieve their targets month after month, then that deflects attention from those root causes. If a service gets to the point where it is over- or mis-using clock pauses then that is unfair to patients, and likely to end in crisis when the position becomes unsustainable. So the intention of this focus on clock pauses is to shine light on them so that they are not over-used, and the root causes of long waits are addressed instead.

Clock pauses are applied by the provider, so here is a map showing where clock pauses have the greatest effect at Trust-specialty level:

Clock pauses by provider
Clock pauses by provider


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