• Dozen hospital trusts will cease individual reporting of performance against 18-week target as part of trial
  • Follows similar move in controversial A&E measures trial
  • New average waiting time measure has been criticised as “meaningless”

NHS England has announced the 12 trusts which will trial the proposed new elective waiting time standard.

NHSE said the dozen trusts, which range in size from very large multisite hospital organisations to smaller specialists, will be testing the use of an average wait figure, as opposed to measuring against the 18-week threshold target.

As with the accident and emergency standards trial, the trusts’ individual performance will no longer be included in the monthly NHSE data release and their August performance against the target will be absent from the October publication.

The trusts trialling the new measure are:

  • Barts Health Trust;
  • Calderdale and Huddersfield Foundation Trust;
  • East Lancashire Hospitals Trust;
  • Great Ormond Street Hospital for Children FT;
  • Harrogate and District FT;
  • Milton Keynes University Hospital FT;
  • Northampton General Hospital Trust;
  • Surrey and Sussex Healthcare Trust;
  • Taunton and Somerset FT;
  • The Walton Centre FT;
  • University Hospitals Bristol Trust; and
  • University Hospitals Coventry and Warwickshire Trust.

The current main referral to treatment time target is for no more than 8 per cent of patients to have been waiting more than 18 weeks. The target has not been hit since February 2016.

The most recent monthly data, for May, was the worst performance against the target since 2008. At 4.39 million, the national waiting list is at its largest since records began.

The 12 trial trusts have a total waiting list of 337,711 – 8.16 per cent of the national total – with only Calderdale and the Walton Centre hitting the existing target in May.

Both Barts Health Trust and Great Ormond Street Hospital for Children FT have faced significant problems accurately reporting a validated waiting list position in recent years.

Barts returned to reporting into the national data set in May 2018, after stopping reporting in August 2014. It currently has 88,695 people on its waiting list.

GOSH restarted reporting in January 2017 after losing track of thousands of patients’ records.

NHSE has confirmed the trusts’ August performance will not appear individually in the national data set from October, although their data and performance will continue to inform the national total.

The move is part of a wider review of waiting times targets ordered last year, with an interim report published in March this year.

However, the average waiting time measure being trialled has already drawn criticism for being “meaningless”.

A&E target trial enters second phase

NHS England also confirmed this afternoon the testing of the new A&E targets would move to its second phase.

The metrics which will be tested in the second phase include measuring time to initial assessment. Test sites will continue monitoring mean average total time in emergency departments and long waits from arrival.

NHSE said sites would also “collect data to examine the feasibility of measuring how fast critically ill or injured patients arriving at A&E receive a package of tests and care developed with clinical experts”.

The list of critical conditions included in testing in this phase is: stroke, major trauma, heart attacks, acute physiological derangement and severe asthma.

New A&E mental health targets will be trialled by neighbouring mental health trusts “later in the process”, NHSE said.

It said in a statement: “[Pilot sites] will be testing standards for urgent community mental health services that can prevent avoidable A&E attendances by providing mental health crisis care in more suitable environments where possible.

“When people do need to attend A&E, the trusts above will be measuring how long people who arrive at A&E experiencing a mental health crisis wait for a psychiatric assessment and, where required, a transfer to appropriate mental health care.”

 

*This story was amended at 3pm on July 25th to reflect NHS England confirmation that the national performance assessment will be calcualted using the data from the 12 trusts