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What a bloody mess.
Seriously ill face longer NHS delays
BY NIGEL HAWKES, HEALTH EDITOR
THE Government’s drive to cut waiting lists has resulted in longer delays for seriously ill patients, an authoritative report from the National Audit Office has found.
More than half the consultants contacted by the NAO said that the order in which they would have chosen to treat patients had been distorted by pressures to cut waiting lists, and one fifth said that this happened frequently.
Managers reduced waiting lists more quickly by scheduling lots of simple operations rather than a few complex ones, it was said. In 80 per cent of the cases, the consultants said, the seriously ill patients had suffered as a result of the delay.
Cutting waiting lists was one of the pledges made by Labour in the 1997 election and enormous pressure was put on hospital chief executives to achieve the targets. There was particular emphasis on the need to reduce numbers waiting longer than 18 months.
The target has meant that less ill patients who are coming up to the 18-month deadline effectively “queue-jump” more needy cases who surgeons feel should be operated on more quickly.
As a result, says the report:
A series of routine hip and knee replacement cases approaching the 18-month threshold were operated on ahead of patients in greater need, who had implants which had failed and were in need of replacement.
A patient with a non-urgent sinus condition who had been waiting almost 18 months displaced more urgent cases.
Three patients with routine ear, nose and throat conditions were given priority over more urgent cases because they were about to breach a trust rule about maximum waiting times.
Operations to reverse vasectomies on patients who had been waiting almost 18 months displaced patients waiting for bladder cancer surgery.
The chairman of the British Medical Association consultants’ committee, Peter Hawker, said: “This confirms what the BMA has been saying for a long time — that waiting lists need to be managed from a patient’s point of view, with the most urgent cases treated first.”
Despite the success in cutting waiting lists by 100,000, there are still more than a million on the lists. The Government has now abandoned waiting lists as a target and is concentrating on reducing waiting times.
The NAO report says that waiting lists and times are too long and that there are huge and unexplained variations across the country.
Some trusts, it says, have also manipulated their waiting lists inappropriately, by taking names off them. It names six trusts where this has happened and says it will be undertaking further work in these cases. The trusts are: Redbridge, Guy’s and St Thomas’s, University College London Hospital, Plymouth, South Warwickshire General and Stoke Mandeville trusts.
A spokesman for the Department of Health said: “The NAO is right to underline the importance of treating patients according to their clinical priority. We expect the NHS to follow this principle and we have repeatedly made this clear.”
David Davis, chairman of the House of Commons Public Accounts Committee, expressed concern that one in five surgeons said that they were regularly forced to distort clinical priorities because of Government policy. “There must be no backsliding from the fundamental principle that those in greatest need are treated first,” he said.
Seriously ill face longer NHS delays
BY NIGEL HAWKES, HEALTH EDITOR
THE Government’s drive to cut waiting lists has resulted in longer delays for seriously ill patients, an authoritative report from the National Audit Office has found.
More than half the consultants contacted by the NAO said that the order in which they would have chosen to treat patients had been distorted by pressures to cut waiting lists, and one fifth said that this happened frequently.
Managers reduced waiting lists more quickly by scheduling lots of simple operations rather than a few complex ones, it was said. In 80 per cent of the cases, the consultants said, the seriously ill patients had suffered as a result of the delay.
Cutting waiting lists was one of the pledges made by Labour in the 1997 election and enormous pressure was put on hospital chief executives to achieve the targets. There was particular emphasis on the need to reduce numbers waiting longer than 18 months.
The target has meant that less ill patients who are coming up to the 18-month deadline effectively “queue-jump” more needy cases who surgeons feel should be operated on more quickly.
As a result, says the report:
A series of routine hip and knee replacement cases approaching the 18-month threshold were operated on ahead of patients in greater need, who had implants which had failed and were in need of replacement.
A patient with a non-urgent sinus condition who had been waiting almost 18 months displaced more urgent cases.
Three patients with routine ear, nose and throat conditions were given priority over more urgent cases because they were about to breach a trust rule about maximum waiting times.
Operations to reverse vasectomies on patients who had been waiting almost 18 months displaced patients waiting for bladder cancer surgery.
The chairman of the British Medical Association consultants’ committee, Peter Hawker, said: “This confirms what the BMA has been saying for a long time — that waiting lists need to be managed from a patient’s point of view, with the most urgent cases treated first.”
Despite the success in cutting waiting lists by 100,000, there are still more than a million on the lists. The Government has now abandoned waiting lists as a target and is concentrating on reducing waiting times.
The NAO report says that waiting lists and times are too long and that there are huge and unexplained variations across the country.
Some trusts, it says, have also manipulated their waiting lists inappropriately, by taking names off them. It names six trusts where this has happened and says it will be undertaking further work in these cases. The trusts are: Redbridge, Guy’s and St Thomas’s, University College London Hospital, Plymouth, South Warwickshire General and Stoke Mandeville trusts.
A spokesman for the Department of Health said: “The NAO is right to underline the importance of treating patients according to their clinical priority. We expect the NHS to follow this principle and we have repeatedly made this clear.”
David Davis, chairman of the House of Commons Public Accounts Committee, expressed concern that one in five surgeons said that they were regularly forced to distort clinical priorities because of Government policy. “There must be no backsliding from the fundamental principle that those in greatest need are treated first,” he said.
