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The penalty for treating a long waiting patient is four times bigger than the penalty for letting them wait. But that isn't the end of the story: because of the target tolerances and how waiting times dynamics work, the perverse incentives are massively bigger than that.
The annual planning round is a bit stale. By transforming planning into a continuous and live management process, we can make sure it changes real life for the better. In a speech to the Association of Professional Healthcare Analysts, I explained how this also creates an important new operational-facing role for analysts.
NHS waits are on the rise - but understanding why is a little more tricky. Here's a handy guide. (First published at openDemocracy)
The health secretary has committed to ending perverse waiting list management. Yet it continues, fuelled by perverse incentives.
The English national waiting list initiative should have got well underway in July. But it didn't: waiting times got worse.
Scotland's outpatient waiting list is building up quite a backlog. The longer it's left, the harder it will be to fix.
Protecting urgent patients is easy if you are willing to waste some capacity. But with a little extra care, you can protect urgents and be efficient at the same time.
The Royal College of Surgeons says urgent patients aren't sufficiently protected by the 18-week and cancer waiting times targets. Their argument is a straw man. But that doesn't mean they are wrong.
Despite a national breach of the admitted patient target, there is no sign that the current waiting list initiative had much effect on long waiters in June. Also the waiting list is edging closer to the point where even the incomplete pathways target could be at risk.
The current governmental flap over elective waiting times is so fascinating, so contorted, and yet so familiar that it is hard to know where to begin.