NHS Waiting Times – The Tip of the Iceberg

  |   MBI Perform

Tip-of-the-Iceberg-207x300As the NAO report into NHS waiting times hits the headlines, highlighting serious discrepancies  in how reported figures have been “miscalculated”, I’m reminded of our previous post on the subject: Lets avoid another crisis


The NAO has estimated that the effect of their investigations would add at least 3 weeks to a patient’s wait if corrected. Jeremy Hunt says the NHS aren’t fiddling the figures deliberately, others plainly disagree.


None of this actually matters.


Either hospitals are incompetent around recording waiting times or they are deliberately recording incorrect times – either way it is unacceptable.


One could also ask what the regulators have been doing.  Do they not monitor this on a monthly basis? Of course they do, but this episode again highlights their complete lack of understanding on RTT and Cancer Waiting Times.


Additionally, it’s boring hearing about how it highlights the need for “culture change”. It doesn’t. It needs action not more deliberation. Not a clampdown on intimidation or a move towards “value based leadership”.


The NHS is currently policy driven rather than service driven. This highlights a need to move the pendulum right back towards operational expertise – I know it’s not sexy, no one goes on the BBC news to explain how to book patients properly but it’s what needs to happen.  Too many of our leaders are lost in a haze of strategic waffle and deliberation.  This highlights the need for on the ground experience.


We have worked with a significant amount of hospitals with respect to RTT. The one common denominator? Every single one of them is reporting incorrectly.


The key areas where inaccuracies occur are few: stopping clocks incorrectly, pausing clocks incorrectly, and the national scandal of the hidden waiting lists with respect to recording patients as being “actively monitored” – in effect removing them from all reporting.


What should be done?


Firstly, the system is too confusing at present and investment in operational expertise is required.


Middle Managers & Clinicians hold the key.


Patients need to be empowered to manage their own waiting times, if they haven’t been seen within 18 weeks there should be a mechanism for them to report it. If patients don’t want to / can’t do this, they should have the ability to nominate an advocate who can do it for them – either a family member or even a system of health “navigators”. Even their GP…the most appropriate advocate.


Data needs to be openly shared with patients and clinicians on a regular basis – ever tried looking it up on the NHS England statistics page? Don’t bother – you need a degree in computer science to make any sense of it. Why bother putting it up there if you don’t want anyone to see it?


Lastly, short-sighted approaches to clinical administration need to be recognised for what they are: false economies where inefficiencies created through the reduction of these staff vastly outweigh any perceived financial saving.


Salami slicing administrative staff should come with the biggest health warning.


But it’s only the tip of the ice-berg.