So new quality measures are in the offing. What about scrapping some of the old ones? Eighteen weeks has created an army of non-jobs, making up the rules, inspecting compliance and finding creative ways to get round them. Yet it is good to treat people soon and know how well we are doing.

There is a simple way to measure the average wait and get everyone focused on improving the flow. Take the number of people on a waiting list and divide by the throughput in a given period. Four hundred people on the list, 40 treated this week, average wait 10 weeks. No clock stops, starts and pauses - and no fudging.

Harry Longman, consultant, The Consultancy Company

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