Frantic rush to hit March target

Trusts are facing a desperate struggle to meet the government's commitment to eliminate outpatient waits of over 26 weeks by the end of next month.

The NHS plan promised a 26-week maximum wait and a reduction in 13-week waits by the end of March. It gave the same deadline for a reduction in the number of 12-month waits for inpatients and a maximum waiting time of 15 months. But despite extra investment and initiatives by the Modernisation Agency to tackle the backlog, outpatient numbers have remained static.

At the end of December, 84,297 people had been waiting for over 26 weeks.

Sources believe that despite pressure from regional offices, the battle to bring the total down to nil may not be won.

One said: 'The figures [for those waiting 26 weeks] have not shifted in around nine months. They have been stuck around the 75,000 mark and I think you will have to be very optimistic to assume the numbers can vanish in just four weeks.'He blamed lack of capacity - particularly staffing - for the failures to bring down the numbers.

On the record, senior managers were loath to admit they might miss the targets but a number said efforts to meet them could distort other priorities, including the government's commitment not to increase the total number waiting.

Bedford Hospital trust has 1,200 outpatients waiting 26 weeks and over for appointments and admits that it faces a severe struggle to meet the targets.The situation is worsened by serious financial difficulties and problems meeting inpatient targets.Trust chief executive Andrew Reed said: 'We know we are not meeting targets in a number of areas, but we are far from resigned to this and we are taking massive steps towards turning these performances around.'

Mr Reed said the trust was 'teaming up with other local hospitals and primary care trusts to increase the number of beds available'.However, not all those on the list have been given appointments and the trust appears unlikely to achieve the target.

Addenbrooke's director of operations Richard Sunley said his trust was hoping for success, having booked appointments by the end of March for 900 patients waiting more than 26 weeks, but it would be very tight: 'The probability is it will be right at the wire. If we get a clinic cancelled because of sickness, it will be difficult.'

Mr Sunley said work on out-patient lists had also led to pressure on inpatient lists and the pledge to cut the total number of patients waiting.

He said orthopaedics, ear, nose and throat and general surgery had faced particular struggles, while problems in dermatology had been assisted by the appointment of specialist GPs and nurses, using money from the Modernisation Agency.But several trusts criticised the effectiveness of the agency in coming to their aid.

One strategy and planning director told HSJ: 'I do not think it has been totally successful in tackling some of the issues trusts are facing - certainly not at the minute anyway.' Another exasperated manager went further: 'You do sometimes wonder what it is the agency is meant to be doing.'

James Paget Healthcare trust head of business and development Keith Barton said he was confident it would meet the 26-week target.But he said efforts on outpatients were causing problems 'around the number of patients on the waiting lists'.

The Department of Health said: 'We made it clear we expect trusts to meet the targets for inpatients and outpatients by the end of March 2002' and said the Modernisation Agency was working with struggling trusts.

The agency was unavailable for comment.