Published: 11/08/2005, Volume II5, No. 5967 Page 20

The government's pledge to reduce waiting times for cancer services to under a month from urgent referral to treatment should provide the catalyst for reducing disparity in waits between providers. There has been progress, but Dr Foster's first cut of the data for the three months to March 2005 suggests there may be difficulties maintaining the momentum.

The latest data from strategic health authorities appears to show some undercount of patients, which could skew the data quality. However, most SHAs are showing rises in average waits for the first quarter of 2005 over the last quarter of 2004.

For example, Dorset and Somerset SHA, where the number of recorded patients is up, has a 6 per cent higher average waiting time.

While Bedfordshire and Hertfordshire SHA was the only one to have reduced waits, it remains the SHA with the highest percentage of patients waiting more than 30 days (see first chart).

There remains a large variation across SHAs by type of cancer (see second chart). Patients in Leicestershire, Northamptonshire and Rutland SHA, for example, wait on average 52 days longer than patients in Trent SHA for breast cancer operations. For urinary tract procedures, there is 40 days difference between neighbouring County Durham and Tees Valley and Northumberland, Tyne and Wear SHAs. These are high-volume procedures, and the relative performances are unlikely to change quickly.

The most telling trend is a rise in waiting times from the 12 months to December 2004 to the 12 months to March 2005 - roughly 10 per cent for cancer. Volumes for the period are mostly in line with what would be expectedand the figure is unlikely to be skewed by the small number of patients with exceptionally long waits.

It is difficult to hypothesise about the reasons for the apparent rise in waiting times, particularly given the flattening out of figures for the year to February 2005. Is the end of the financial year significant? Is there a slow-down in activity to move patients into the following financial period?

Is there pressure to admit those with the longest waiting times before the end of March?

The third chart demonstrates the challenge facing SHAs with a high volume of patients with cancer types that have traditionally meant long waiting times. Regardless of whether overall waits are falling, patients with cancer of the skin, urinary tract or male genital organs are still waiting around 15 days longer than the government target for all cancers. .

Dr Marc Farr is product development manager at Dr Foster (phone 020-7256 4916 or visit www.

drfoster. co. uk).

The next Dr Foster page is on 15 September and will cover emergency admissions.