Trusts have managed to meet a high profile waiting time target just weeks before the general election.
- “Incomplete’” target met by trusts, despite pressures on A&E causing bed shortages
- Some trusts have spent extra treating long waiting patients, above the £250m government fund
- “Long term growth” of waiting list an issue for next government
The “incomplete” target, which requires 92 per cent of patients to be waiting no more than 18 weeks to start treatment, was achieved in February at 93.1 per cent.
This comes despite a high number of cancelled elective operations because of bed shortages following what was widely thought to be the toughest winter for accident and emergency departments in recent years.
There was a 29 per cent increase in admitted patients waiting over 18 weeks compared to February last year.
At 10 weeks, the median length of time admitted patients waited for treatment was at its highest since 2008.
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One trust chief executive told HSJ that it had been a struggle to balance all the performance targets throughout the winter for elective work and accident and emergency.
As A&E pressures increased and the referral to treatment backlog grew so did political pressure on the system, the chief executive said.
Trusts have spent the last eight months clearing backlogs of patients waiting over 18 weeks.
This work was funded by the Department of Health, which gave £250m to clinical commissioning groups to distribute to trusts.
However, some trusts have seen the bill for treating these long waiting patients exceed their share of the government funding.
Oxford University Hospitals Foundation Trust told HSJ it spent £7.2m on top of the £4.3m it received from the central fund.
University Hospitals Birmingham Foundation Trust said it spent an extra £4.3m above the £349,000 it was given.
Waiting times expert Rob Findlay said it was “open to question” how successful the waiting list initiative to clear the longest waiting patients had been because admissions “have not been particularly higher than in recent years”.
He said that while “record proportions” of long waiting patients were treated in February this was due to the amnesty on imposing the admitted and non-admitted targets.
NHS England has toughened up the penalties for breaches of the referral to treatment targets in the 2015-16 contract.
Mr Findlay added: “Perverse waiting time targets are coming back with a vengeance from April, there are going to be mandatory sanctions on the perverse targets. The short term waiting list initiative will come to an end, which leaves us with a waiting list that’s on the brink of breaching and the long term position is that the waiting list has been growing.
“It is only a matter of time before the main waiting times target, the 92 per cent target, is breached. This is something for the next government to address but that is likely to require long term investment.”
There were 2.9m patients on the waiting list in February, however this does not include eight trusts which did not report their waiting list size.
Both the admitted and non-admitted targets were missed by the sector. However, Monitor, NHS England and the NHS Trust Development Authority wrote to trusts in February giving permission for the targets to be breached in an effort to try and clear the longest waiting patients.
Only 87 per cent of admitted patients and 94.7 per cent of non-admitted patients began treatment within 18 weeks.
A spokesman for NHS England said: “In February the NHS made further strides in cutting long waits, with the number of patients who waited over a year slashed from over 5,000 three years ago to being in the hundreds now, and with the average wait for an operation being just 10 weeks.”