The number of over one year waiters on the English waiting list shot up 20 per cent in February, as the elective admission rate continued to slump in the face of exceptional winter pressures.
Nor is there any relief in sight. The type one accident and emergency data, which is released a month ahead of referral to treatment waiting times data, showed record poor A&E performance continuing through March, suggesting winter pressures may hammer RTT admission rates for some time to come.
Waiting times edged up in February, which is ominous because normally there is a seasonal improvement at this time of year.
Liverpool Women’s Foundation Trust restarted reporting after a month absence. Its waiting list is quite small so this makes little difference to the national figures. Overall, the estimated number of unreported waiting list patients remains close to the record high – nearly 300,000 – set in November.
The waiting list grew slightly in February, which is typical of the season. The triangle in the graph below shows a large reduction in the national waiting list would be needed to restore the NHS constitution’s 18 weeks standard, even if national waiting list management returned to the tighter 2013-16 levels.
Talking of national waiting list management, the chart below shows this remains looser than the 2013-16 average, which is a sign of a higher level of inequality of waiting times across the country.
Admissions per working day continued the spectacular collapse seen in January, when elective admissions were cancelled to release beds for emergency patients.
The number of one year waiters shot up by 20 per cent in February from 1,869 to 2,236 (or, if you adjust for the last known positions at non-reporting trusts, from 2,119 to 2,486). Either way this is the worst performance on one year waits since July 2012 when long waits were falling sharply after the successful introduction of the incomplete pathways standard.
At specialty level, rheumatology slipped in February, leaving only geriatric medicine and general medicine in national compliance with the 18 week standard. They aren’t big waiting list specialties though: between them they comprise less than 2 per cent of the total waiting list.
Of the 2,500 local specialties within trusts, only 57 per cent are now achieving the 18 week standard. If this rate of decline continues, achieving the target will be a minority sport by autumn.
If you plot the waiting times of those 2,500 local services, after sorting them in order, you get the curve shown below. The point where the red line crosses 18 weeks is the value charted in the time series above.
The long waiting end of the curve is continuing to peel up from the 18 week line, as waiting times become more unequal around the country. A year ago, the standard deviation of these waiting times was 5.2 weeks. Now that inequality has increased to 5.8 weeks.
There was some jostling at the bottom of the table of longest waiting trusts in February with four new entrants. Aside from that it is quite astonishing that a trust’s waiting time has to be over 25 weeks even to make it into the top 20.
The statistics calendar for 2018-19 has been published, and RTT data for March is due out on 10 May.
Rob Findlay is director of the software company Gooroo, specialists in demand and capacity planning.
- Acute care
- BARTS HEALTH TRUST
- BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST
- EAST AND NORTH HERTFORDSHIRE NHS TRUST
- EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST
- East of England
- Emergency care
- GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST
- HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST
- IMPERIAL COLLEGE HEALTHCARE NHS TRUST
- KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST
- KING'S COLLEGE HOSPITAL NHS FT
- LONDON NORTH WEST HEALTHCARE NHS TRUST
- MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST
- MEDWAY NHS FOUNDATION TRUST
- MID ESSEX HOSPITAL SERVICES NHS TRUST
- NORFOLK AND NORWICH UNIVERSITY HOSPITAL NHS TRUST
- North West
- NORTHERN DEVON HEALTHCARE NHS TRUST
- NORTHERN LINCOLNSHIRE AND GOOLE HOSPITALS NHS FOUNDATION TRUST
- Patient experience
- PLYMOUTH HOSPITALS NHS TRUST
- Quality and performance
- QUEEN VICTORIA HOSPITAL NHS FOUNDATION TRUST
- ROYAL CORNWALL HOSPITALS NHS TRUST
- ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST
- ROYAL ORTHOPAEDIC HOSPITAL NHS TRUST
- South East Coast
- South West
- Specialist care
- ST GEORGE'S HEALTHCARE NHS TRUST
- UNIVERSITY HOSPITALS OF NORTH MIDLANDS NHS TRUST
- Waiting lists
- WIRRAL UNIVERSITY HOSPITAL NHS TRUST
- WYE VALLEY NHS TRUST
- Yorkshire and the Humber