Waiting times across England

Waiting times held steady in June, and continue to follow the seasonal trend. Ten per cent of the waiting list was over 17.2 weeks, the same as in May; and 90.2 per cent of admitted patients were treated within 18 weeks (compared with 90.8 per cent in May). In the chart below, the dotted line shows the waiting list (the so-called incomplete pathways) at the end of June, and the solid line shows patients who were admitted for treatment during June.

The total number of patients on the waiting list is also following the seasonal pattern of the last couple of years (as the next chart shows). If this carries on, it might mean a repeat of last year’s winter backlog (the hump in the dotted line in the chart above) which was followed by breaches of the headline admission-based target as the NHS recovered from it in the spring.

The total list size levelled-off in June as a result of increased elective activity (see chart below). This increase in admissions is in line with the pattern of previous years; there are two bank holidays in May but none in June. It is worth noticing that there is no evidence here of elective activity slowing down this year as a result of any financial constraints.

For more detail on the English figures you can download our RTT waiting times fact checker, which contains complete time series for all the main English waiting time measures, here:

RTT waiting time fact checker.xls

Waiting times by Trust

As always, the national picture conceals huge variations from Trust to Trust. In the following chart, each English Trust is represented by two dots: a red one and a blue one. The red dots show how long the top ten per cent of the waiting list is still waiting at the end of June (incomplete pathways). The blue dots show how long the top ten per cent of patients admitted during June had waited before they were treated (adjusted admitted pathways).

You might expect that, if a Trust had lots of long-waiting patients, then it would admit lots of long-waiting patients in an effort to clear the backlog. But one of the interesting things about this chart is it shows that this doesn’t always happen. If you look at the right hand side of the chart, where you’ll find the Trusts with the longest waiting times, you can see plenty of blue dots under the 18-week line. Those Trusts are “achieving the target” even though they have plenty of long-waiting patients on their waiting lists; so long as they only admit one long-waiter in every ten admissions, they will achieve the headline “90 per cent admitted within 18 weeks” target.

The proportion of Trusts, where at least 90 per cent of patients on the waiting list are under 18 weeks, has improved slightly since May. At 70 per cent, this is the best since July 2010. The next chart shows the trend; this chart is related to the one above because it tracks the point where the red line (in the chart above) crosses 18 weeks.

Looking across England, which Trusts have the greatest waiting time pressures? Based on the waiting list (incomplete pathways) the top 20 is:

Kingston have gone straight in at #1 having failed to submit incomplete pathways data since March. I don’t have any local knowledge of what has been happening there, but I know that a few journalists are on the trail (after I tweeted their figures this morning). So more details will probably emerge later today.

You can find full details of the position at each Trust, including time trends, via the interactive maps below: click on a pin to get a balloon showing a summary of any Trust’s data, and then click on the Trust name in the balloon to get a full analysis with charts.

There are separate maps for each specialty (all maps based on incomplete pathways):

General Surgery | Urology | Orthopaedics | ENT | Ophthalmology | Oral Surgery | Neurosurgery | Plastic Surgery | Cardiothoracic Surgery | Gynaecology | All specialties combined

To find the greatest waiting time pressures around England, in any specialty, click the map below. It shows the 100 services where the top 10 per cent of the waiting list is waiting the longest.

If you have a particular Trust in mind, you can directly look up its detailed reports here.

Sadly, all the above analysis comes with a caveat: in many parts of England there are restrictions on hospital referrals that have the effect of blocking or holding up patients before they arrive on the hospital waiting list. Those patients are not included in the reported figures, and so they are missing from this analysis.

The July 2011 waiting time figures are due out at 9.30am on Thursday 15th September.

This post first appeared at HSJ blogs.