Comments - Page 2
A few more suggestions that have been put to me since I posted this:
Some missing waiters around the nine-week mark could be Choose & Book patients, who were told by C&B that no appointments were available and therefore raised an ASI (Appointment Slot Issue). Those patients might then be managed on paper by the hospital until their slot is arranged, which might take several weeks, during which they might not be reported as incomplete pathways. (Incidentally, this is a wasteful and risky administrative process, and the patient usually ends up in a similarly-dated slot to the one they would have had if C&B polling ranges had simply been extended.)
Some missing patients close to the 18-week mark at Trust level (though not at national level) are tertiary referrals. These arrive at the tertiary centre with time already on the clock (although there is now the option for the referring provider to take the 'hit' on any breaches caused by delays at their end: http://transparency.dh.gov.uk/files/2012/06/RTT-Reporting-patients-who-transfer-between-NHS-Trusts.pdf).
Thanks Anonymous 2:51pm - I agree that involuntary waits should be a lot shorter than they are. But the 12-week Scottish target you quote is just for the inpatient/daycase stage of treatment; both Scotland and England set 18 weeks as the standard for referral-to-treatment waiting times.
“We offer a choice of two dishes each day and two desserts, and they can also have fruit afterwards if they choose. We also use more milkshakes, and smoothies made with real fruit.”
So that's dessert (added sugar), fruit (natural sugar), milkshakes (added sugar), and smoothies (lots of natural sugar) after every lunch and dinner and in between.
An improvement, no doubt, on what went before. But is all that sugar really good nutrition?
Bexley levelled GP incomes back in 2009, moving from a price range of £59 to £158 per weighted patient to a flat rate of £75.
(See June 2008 Board papers for details: Enc F at http://www.bexley.nhs.uk/About-Us/Board-Papers-2008.htm)
Anonymous 10:13am: b) is accepted, and I agree that fiddles do happen from time to time. But they would need to be very widespread and large-scale for the apparent improvements of the last 2 years to be an illusion. Do you have evidence that they are?
Thanks, Anonymous! We built our own discrete event simulation model, which simulates booking individual patients into slots. If you follow the link in the article to my parallel blog post, you'll find details there.