PERFORMANCE: A new report by the trust lists confusion caused by a new patient administration system and commissioner refusal to pay for additional activity among the causes of its steep decline in waiting list performance.

The report describes WUTH as an “extreme outlier” in terms of the proportion of patients it has still waiting for treatment after the 18 week cut off point.

The foundation estimates that at the end of December 2011 it had 7,998 patients who appear to have waited for longer than 18 weeks. Of those patients, 51 have apparently been waiting for more than a year.

The report states that WUTH’s performance began to deteriorate in 2010, after the government stopped performance management of the 18 week target.

It continues: “In December 2010, NHS Wirral requested that all waiting list initiatives stopped apart from cancer patients and in exceptional circumstances. They confirmed that they would not fund the full level of activity required to deliver 18 week targets.”

For 2011-12 the commissioners did agree to fund an extra £3.3m of activity to help the foundation hit the target.

However, the introduction of a new patient administration computer system in November 2010 had led to thousands of incorrect entries. This, it says, “made accurate management of waiting lists in time order very difficult. In addition, it was difficult to accurately monitor and predict 18 weeks RTT performance.”

Among other “key issues”, the report notes: “In 2010, the commissioners across Cheshire and Merseyside undertook a review of vascular surgery. A recommendation was made to appoint the Countess of Chester Hospital as a Vascular Centre. Following which, a number of concerns were raised by clinicians regarding the process and outcome.

A trust-wide vote of no confidence was taken by consultants and, as a consequence, the chief executive made the decision to resign from post. The deputy chief executive was appointed acting chief executive. The complex clinical and political debates diverted attention from 18 weeks performance.”