Hospital waiting times tracker: April 2011

The White Paper, Equity and excellence: liberating the NHS, sets out a significant set of reforms for the NHS over the coming years. As we do with all new major policy developments, The King's Fund will follow the evolution and implementation of these changes and assess their impact. As part of this evaluation we will collate and comment on key aspects of NHS performance, starting with hospital waiting times.

Please note: This page is no longer being updated as data is now being collated and analysed as part of the Quarterly monitoring report

April 2011: 18-week limit back in force?

In his speech on 7 June setting out his five pledges for the NHS, David Cameron noted the importance of waiting times to patients and the public. He promised that published information on waiting times would, amongst other things, help patients choose which hospital to attend. But while choice may help keep waiting times low – why would any patient choose hospitals with long waits? – in practice there's no guarantee.

And so, David Cameron also said:

'But we're not going to leave anything to chance, especially as our changes are working their way through the system. So we're keeping the 18-week limit. That's in the NHS Contract and Constitution. And it's staying.'

A belt and braces approach to waiting times is called for it seems. So what's happening to our tracker this month?

Median waiting times

The latest 18-week referral to treatment waiting times data for April 2011 are shown in the figures below.

Latest median waiting times (the time waited by the person halfway between the shortest and longest wait) for the referral to treatment pathway show some mixed changes on March figures and in terms of what might be expected given past seasonal trends for April.

Click on the graphs below to expand them

Patients still on waiting lists waiting more than 18 weeks

For people still on a waiting list, the median wait has increased compared with March, but this is more or less in line with previous seasonal trends.

Patients still on waiting lists waiting more than 18 weeks Apr 11

Patients treated in outpatients who waited more than 18 weeks

For those who attended outpatients, median waits increased very slightly, but much less than might be expected in terms of the trends for April in previous years.

Patients treated in outpatients who waited more than 18 weeks Apr 11

Patients admitted as inpatients who waited more than 18 weeks

Median waits for people admitted as inpatients showed a small fall – as might be expected for April.

Patients admitted as inpatients who waited more than 18 weeks Apr 11

All sources: adapted from: Department of Health: Referral to treatment waiting times statistics

Patients waiting longer than 6 weeks for a diagnostic test

However, median waiting times for diagnostic services increased in April compared with March – from 1.8 to 2.3 weeks – an unexpected increase (in the past three years median waits have reduced in April). It is also the highest April waiting time since April 2007.

Patients waiting longer than 6 weeks for a diagnostic test Apr 11

Source: adapted from: Department of Health: Diagnostic waiting times statistics

So are waiting times improving?

The proportion of people who waited more than 18 weeks as outpatients, inpatients or those still on waiting lists all fell compared with March. The 18-week waiting statistics have much less of a noticeable seasonal pattern than median waiting times so it is difficult to compare these changes with what might have been expected for this time of year.

Unfortunately for the Prime Minister, as the graph below shows, while just under eight out of ten hospitals met this limit, 49 (26 per cent of) NHS hospitals breached this target for some patients in April.

(Note: the previous government's 18-week target was set at 90 per cent of admitted patients to allow for variations in clinical need and patient choice in the timing of an admission).

Proportion of patients who waited less than 18 weeks prior to admission as an inpatient by hospital (adjusted figures)

Source: adapted from: Department of Health: Referral to treatment waiting time statistics