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Why don’t we know if waiting times are going up or down?

http://www.pulsetoday.co.uk/practical-commissioningl

I am going in. This blog is about the subject of waiting times.

David Cameron says waiting times are down,  Ed Miliband says they're up. The answer it seems – eyes roll – is that they are both ‘right'.

I came across the excellent fullfact.org.uk website the other day which enlightened me and shows how the political soundbite depends on which measure you use.

Official NHS data records three different measures says fullfact: the average (median) time taken for a patient's procedure to be completed in weeks; the period in weeks that the longest-suffering 5 per cent wait for treatment; and the proportion of patients seen within 18 weeks.

Using the median waiting times have gone from 8.4 weeks to 8.1 since this Government came to power.

But the measure of the number of patients waiting more than 18 weeks which is perhaps the measure most likely to really affect individual patients lives -shows this has increased going from 92.9 seen within 18 weeks in May 2010 to 91 per cent in November 2011. The third measure – the 95thpercentile of those waiting the longest for treatment – has also ticked upwards slightly, with this group waiting a week longer now than the 21.2 weeks they were at election time.

Now, putting the political ‘hay' that can be made out of the stats to one side my question is why isn't it clearer which measure is the one most likely to affect patients lives in terms of outcomes? Are commissioners clear in their minds which stat they need to see change locally? And this waiting time trajectory shouldn't just be one for commissioners – the public needs to be reassured the most robust measure is being used if it is to be convinced the NHS is not going to the wall.

To really get to know what's happening with waiting times locally is going to take a fair bit of manpower. There's the alleged ‘gaming' for a start – a patient starts on one list, sees a consultant, gets moved to another list and so the waiting list speedwatch is reset again.

But think on this. At a conference last year a foundation trust chief executive asked the audience how many reports came out of his organisation in a year. The answer a Space Odyssey-like 2002 – but actual usual information much less. We have so much data in the NHS but we don't have a definitive answer on something as important and contentious as waiting times.

And it's going to need ‘soft intelligence' too to overcome any gaming. X number of patients are going to be needed to be tracked and interviewed to ask what their actual waiting time experience was really like.

And finally it appears there needs to be some work done in managing patient expectations on waiting times if one comment left on a Guardian story about waiting times is anything to go by.

‘My daughter wanted a appointment with her doctor on Tuesday but didn't get an appointment until the Thursday – and they expect GPs to run the NHS?!'

 

Sue McNulty is editor of Practical Commissioning

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