Yet another large trust stopped reporting its referral to treatment data, which clouded the picture for the latest November figures and raised non-reported waiting lists to a new record. But overall the waiting time picture was “steady as she goes” – despite continued low rates of patients being admitted from the waiting list.
With patients being admitted from the waiting list at the slowest rate in years, and waiting list management running loose, you might think that waiting lists and waiting times would have risen in the autumn. Not so, according to the November figures just released by NHS England.
Unfortunately, the picture is clouded by another large trust going on “reporting holiday”. But even if you factor that back in, waiting list growth held to just 4 per cent annually, which is low enough to stop waiting time pressures from rising. Waiting times duly eased back to just over 20 weeks.
Waiting times eased back slightly to 20.2 weeks in November on the reported figures, remaining well above the 18 week standard which has been breached since March 2016.
The Royal Orthopaedic Hospital Foundation Trust started reporting RTT data again, but the much larger Mid Essex Hospital Services Trust stopped. This brought the estimated number of missing patients to nearly 300,000 – the largest number ever and comfortably beating the previous record of 266,000 set the previous month.
Returning to the published figures, which do not factor in non-reporting trusts, we find the picture is unfortunately heavily skewed by non-reporting.
The apparent sharp drop in the size of the reported waiting list (shown in the chart below) is an illusion caused by non-reporting trusts. When those non-reporters are added in, we find the waiting list did fall slightly, which is not unusual for the time of year. We also find year on year growth in the waiting list has remained close to 4 per cent annually since April, which is low enough to stop waiting time pressures from rising.
But waiting times did rise sharply in August caused by something else: a loosening of waiting list management (as the chart below shows). Since that unexpected change, the index of waiting list management has remained slack compared with recent years.
Admissions per working day remained low. It is possible that competition with non-elective services for beds could be the cause of both looser waiting list management and the relatively low admission rate.
The reported number of ultra long waits remained high, though these figures are strongly affected by non-reporting trusts and should not be relied on.
The 18 week standard continues to be breached nationally in all specialties except for three medical specialties.
The proportion of local specialties within trusts, which are achieving the 18 week standard, remained roughly steady at 63.5 per cent meaning more than one third of local services continue to breach the standard.
The distribution of local specialty waiting times remained steady, in line with the overall picture.
The table of the top 20 longest waiting providers also changed little from the previous month.
Data for December 2017 is due out on 8 February.
Rob Findlay is a specialist in demand and capacity planning, and director of software company Gooroo
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