This site is intended for health professionals only

Hospital waits soar after end of 18-week target

By Alisdair Stirling

Exclusive: Tens of thousands of GPs' patients are now waiting more than 18 weeks from referral to treatment following the Government's decision to scrap performance management of the flagship target.

The number of patients missing out on treatment within 18 weeks of referral jumped by 15% between July and September this year, after PCTs were released from their strict obligation to meet the target in June.

Legal experts warned the rise could leave GP consortia at risk of being sued by patients when they take over commissioning, since being treated within 18 weeks remains a right under the NHS Constitution.

Department of Health statistics show the proportion of people treated within 18 weeks increased steadily from 2007. Numbers peaked this July, when 93.3% of admitted and 98.1% of non-admitted patients were treated within target, just after the NHS Operating Framework removed it. By September, the proportion of admitted patients missing out jumped from 6.7% to 7.5%, and of non-admitted patients from 1.9% to 2.2%.

Overall, 45,000 patients missed out on treatment in 18 weeks during September, up 15% from 39,000 in July. Some 12.6% of patients awaiting orthopaedic or trauma treatment, and 10.6% awaiting oral surgery, waited more than 18 weeks.

Ben Troke, partner in health and social care at Browne Jacobson solicitors, warned: ‘When commissioning passes to GP consortia, it's hard to see responsibilities [for applying the NHS Constitution] not going with it. There's a real risk of legal challenge.'

‘Whether a claim would be successful is hard to say, but being dragged through the courts can be damaging even if you win. Courts are starting to rely on the NHS Constitution as a ground for decisions and every consortium can expect to keep their lawyers busy.'

At least one SHA has admitted waiting times are slipping. NHS South Central said health systems in Oxfordshire, Southampton and south-west Hampshire had been assessed as failing ‘principally due to financial issues and concerns on workforce and 18 weeks'.

Dr Jennifer Dixon, director of the Nuffield Trust, said: ‘Once you scrap hard targets, it's likely actions to achieve them will wane. I guess that's what we're starting to see.'

Dr Chaand Nagpaul, GPC negotiator, said PCTs were already taking advantage of the target's removal: ‘We're getting reports of trusts delaying treatment so they can address financial problems. The Government is engaging in double-speak, removing targets on one hand but committing to patients' rights on the other.'

Thousands of patients have faced increased waits since the 18-week target was scrapped Thousands of patients have faced increased waits since the 18-week target was scrapped