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Page last updated: 26-MAY-2009

Waiting Times

 

ONS kitemarkStatistical Publication Notice

26 May 2009

Waiting times and waiting lists to 31st March 2009 (monthly and quarterly data)

INTRODUCTION

It is important to note that the Scotland and NHS Board-level statistics derived from the 'New Ways' waiting times data warehouse in this publication are classed as provisional. This is described in more detail below. Data published in previous quarters are updated in this publication to reflect ongoing work by NHS Boards to improve data quality. Further information is discussed on the data quality page.
 
This is the fifth publication of waiting times statistics following the introduction of 'New ways of defining and measuring waiting times' on 1 January 2008. There is no continuity from the previous method of measuring waiting and the new method. Please see the National Statistics notice for more information.
 
Waiting times are important to patients and are a measure of how the NHS is responding to demands for services. Measuring and regular reporting of waiting times highlights where there are delays in the system and enables monitoring of the effectiveness of NHS performance throughout the country. The NHS in Scotland has been set a number of targets for maximum waiting times. The Scottish Government continues to be committed to improving information on waiting to provide a clear and transparent picture of NHS performance.
 
The NHS has been engaged since 1 January 2008 in the implementation of new waiting list rules and definitions. New Ways is a very complex project, involving thousands of NHS staff. The aim is that this system makes the process (or pathway) of waiting more transparent to the public and is inclusive of patients who formerly would have been excluded from waiting times standards.
 
Data quality
Given the level of new data collection involved, some impact on the quality of data was expected, and observed, as the 'New Ways' of recording patient activity and waiting times were implemented.
 
ISD put in place a process to judge the fitness for publication of statistics derived from the new waiting times data warehouse, and published a document in May 2008 describing the process. This same process has been used for this publication. ISD also used management information available to NHS Boards to help evaluate the quality of key statistics relating to national waiting times standards. On the basis of these processes, ISD determined which figures required clarification in footnotes or, in a small number of cases, could not be shown.
 
Please note: there are apparent anomalies between figures published from New Ways and Acute Hospital Care data sources. Some of the figures for Elective Admissions and New Outpatients in 'New Ways' appear to be considerably lower than the equivalent information published on the Acute Hospital Care web pages. This is largely due to the use of different definitions between the two sets of figures. For example, Acute Hospital Care information includes non-waiting list cases and non GP/GDP referrals, which do not form part of many of the published Scotland figures in 'New ways'. ISD are carrying out further detailed investigations into these differences.
 

KEY POINTS

  • At 31 March 2009, 100% of new outpatients and over 99.9% of inpatients and day cases were waiting less than the 18-week national standard. This is the statistic used by NHS Boards from 31 December 2007 to 31 March 2009 to measure performance against Scottish Government waiting times standards.
  • At 31 March 2009, over 99.9% of new outpatients and approximately 99.9% of inpatients and day cases were waiting less than 15 weeks. 15 weeks is the new national standard that comes into place from 31 March 2009 and will be the statistic used by NHS Boards to measure performance against Scottish Government waiting times standards from this date.
  • 99.9% of new outpatients seen and 99.9% of inpatients and day cases treated in quarter ending 31 December 2008 had waited less than 18 weeks.
  • 98.4% of new outpatients seen and 98.2% of inpatients and day cases treated in quarter ending 31 December 2008 had waited less than 15 weeks.
  • At 31 March 2009, there were 1,880 patients waiting for cataract assessment, of which 99.9% were waiting equal to or less than the local target.
  • A small number of patients waiting for angiography were reported as waiting longer than local targets. No patients were waiting longer than local targets for revascularisation or valve surgery.
  • 2.8% of new outpatients and 18.9% of inpatients and day cases on waiting lists at 31 March 2009 were unavailable for treatment at that date.
  • 97.2% of patients attending Accident and Emergency (A&E) departments during the quarter ending 31 March 2009 were admitted, discharged or transferred within 4 hours.

INTERPRETATION

  • Waiting times information for inpatients, day cases and outpatients are derived from the 'New Ways' compliant waiting times data warehouse. These statistics are provisional and may be updated in subsequent publications. (Data quality)
  • This is the fifth publication of waiting times statistics following the introduction of 'New ways of defining and measuring waiting times' on 1 January 2008.
  • 'New Ways' introduced a significant change in how the NHS Scotland collects and defines waiting times, and also how waiting lists are clinically and administratively managed.
  • One very important policy aspect of this change is that many patients who would previously have been excluded from national standards for waiting are now included. This change takes account of any periods of unavailability and missed or cancelled appointments. All waiting times statistics derived from the new ways waiting times data warehouse are produced on this basis.
  • Under 'New Ways', patients waiting for a new outpatient consultation at a consultant-led clinic or for inpatient and day case treatment who become unavailable for medical or social reasons are no longer exempt from national waiting times standards.
  • There are two measures of waiting times ; monthly censuses of patients waiting at the end of each month and the reported waiting times of patients who have been seen or treated. An explanation of these two measures is available.
  • Some NHS Boards have reported that certain statistics are not yet finalised and may be subject to some change. These are published, where they are considered to give a reasonable reflection of the current position and therefore to be useable by the public. In such cases, details of differences between the published figures and current local NHS Board understanding are shown in the footnotes to the relevant table.

DETAILED FINDINGS

Provisional statistics derived from the new waiting times data warehouse

These figures are subject to revision by some NHS Boards - see footnotes of tables for more details.

New outpatients - patients waiting at month end
  • The national waiting time standard in place from 31 December 2007 to 31 March 2009, stated that patients should wait no longer than 18 weeks to attend a consultant-led new outpatient clinic after being referred by their General Medical Practitioner (GP) or General Dental Practitioner (GDP). The latest available information shows that 100% (a total of around 154,000) had been waiting 18 weeks or less at 31 March 2008.
  • The current national waiting times standard, in place from 31 March 2009, is that patients should wait no longer than 15 weeks. Over 99.9% had been waiting 15 weeks or less at 31 March 2008. This compares to 99.5% at 31 December 2008. 
  • The total number of patients on waiting lists for a new outpatient appointment at 31 March 2008 was recorded as around 154,000. Of these, 2.8% were unavailable for an appointment on 31 March 2009. This compares to 4.2% at 31 December 2008.
New outpatients - patients seen during the quarter
  • Over 99.9% of patients (from a total of around 236,000 referred by their GP or GDP) seen during the quarter ending 31 March 2009 waited for 18 weeks or less; 98.4% waited 15 weeks or less. This compares to quarter end 31 December 2008 figures of 99.8% and 92.2% respectively.
  • One half of patients seen at outpatient departments during the quarter ending 31 March 2009 waited 43 days or less (median). This is a decrease from median of 48 days for quarter end 31 December 2008.
  • The 90th percentile wait indicates the maximum time 9 out of every 10 patients waited. For the quarter ending 31 March 2009 this was 87 days. This is a decrease on the figure for quarter end 31 December 2008 (102 days).
  • 88.3% of patients did not cancel, fail to attend, or have periods of medical or social unavailability that affected their overall waiting time. This compares to 89.1% for quarter end 31 December 2008.
New outpatients - waiting list activity

During the quarter ending 31 March 2009 around 417,000 patients (referred by any source) were removed from a waiting list for a new outpatient appointment. Of these, 80% of patients were removed because they had attended an appointment. 7% were removed because they were referred back to their GP, 6% were removed because they no longer required treatment, 3% were transferred and 5% were removed for other reasons.

Inpatients and day cases - patients waiting at month end
  • The national waiting time standard in place from 31 December 2007 to 31 March 2009, stated that patients should wait no longer than 18 weeks for inpatient or day case treatment. At 31 March 2009, over 99.9% (from a total of around 66,000) had been waiting 18 weeks or less.
  • The current national waiting times standard, in place from 31 March 2009, is that patients should wait no longer than 15 weeks. 99.9% had been waiting 15 weeks or less at 31 March 2009. This is an increase on the 31 December 2008 figure (99.4%).
  • The total number on waiting lists for inpatient and day case treatment at 31 March 2009 was recorded as around 66,000. Of these, 18.9% were unavailable for an appointment on 31 March 2009 (almost two thirds of which were due to social unavailability). This is a decrease from 22.7% at 31 December 2008.
Inpatients and day cases - patients seen during the quarter
  • 99.9% of patients seen (from a total of around 105,000) during the quarter ending 31 March 2009 waited 18 weeks or less; 98.2% waited 15 weeks or less. This shows an increase from quarter end 31 December 2008 figures for patients waiting 18 weeks or less (99.7%) and an increase for patients waiting 15 weeks and less (95.6%).
  • One half of patients admitted for inpatient and day case treatment during the quarter ending 31 March 2009 waited 32 days or less (median). This is up from a median of 31 days for quarter ending 31 December 2008.
  • The 90th percentile wait indicates the maximum time that 9 out of every 10 patients waited. For the quarter ending 31 March 2009 this was 82 days. This is a reduction on the quarter end 31 December 2008 figure (90 days).
  • 82.3% of patients did not cancel, fail to attend, or have periods of medical or social unavailability that affected their overall waiting time. This compares to 86.3% for quarter end 31 December 2008.
Inpatients and day cases - waiting list activity
  • During the quarter ending 31 March 2009 around 123,000 patients were removed from a waiting list for an inpatient or day case admission. Of these, 85% were removed because they were admitted as planned, 9% were removed because they no longer required treatment, 3% were removed because they were referred back to their GP, 2% were transferred and 2% were removed for other reasons.
"Whole Journey" waiting times for cardiac and cataract

Referral to treatment targets for cardiac treatment and cataract surgery have been in place since 31 December 2007. NHS Scotland currently lacks systems on a national basis to capture total patient journey information. A pragmatic interim solution has been to measure and report the best available information about the components (outpatient assessment, investigations and treatment) of these journeys. This will be an indicator of progress towards the targets. The information being published is based on data under development and the quality and accuracy are being monitored by ISD.

Cardiac
  • The current national waiting time standard states that no patient will wait more than 16 weeks for cardiac intervention following GP referral through Rapid Access Chest Pain Clinic (RACPC) and no patient will wait more than 16 weeks for treatment after they have been seen as an outpatient by a heart specialist who has recommended treatment.
  • Cardiac services are delivered on a regional basis and each region has set local targets for the cardiac journey component parts while ensuring that the total maximum wait meets the national target of 16 weeks.
Cardiac - key points

At 31 March 2009:

  • 406 patients were waiting for angiography, 411 for revascularisation, 158 for valve surgery and 776 patients for other cardiac surgery.
  • Of the 406 patients waiting for angiography, 99.5% were waiting equal to or less than the local target. This compares to 98.8% at 31 December 2008.
  • Of the 411 patients waiting for revascularisation, 100% were waiting for 10 weeks or less. This compares to 100% at 31 December 2008.
  • Of the 158 patients waiting for valve surgery, 100% were waiting for 10 weeks or less. This compares to 99.0% at 31 December 2008.
  • Of the 776 patients waiting for other cardiac surgery, 100% were waiting for 16 weeks or less. This compares to 99.9% at 31 December 2008.
  • Statistics on patients seen at a RACPC will not be published at this time, as they require some further work in order to improve their reliability.
Cataract
  • The current national waiting time standard states that the maximum wait from referral by a GP or optometrist to surgery should be 18 weeks.
  • Due to local service configurations, NHS Boards have set local targets for the cataract journey component parts while ensuring that the total maximum wait meets the national standard of 18 weeks.
  • Data on patients waiting for outpatient assessment for cataract is presented for first time, for 31 March 2009, in this publication.
  • At 31 March 2009, there were 1,880 patients waiting for cataract assessment, of which 99.9% were waiting equal to or less than the local target.
  • Waiting times data for cataract surgery are not presented at Scotland level, as they require further work in order to improve reliability.

Statistics shown below are derived from a range of other (non New Ways waiting times) datasets

Hip fracture

The current national standard, in place from 31 December 2007, states that 98% of all hip fracture patients should be operated on within 24 safe operating hours of admission to an orthopaedic unit, subject to medical fitness. Safe operating hours are between 8 am and 8 pm, seven days a week.

Hip fracture patients admitted after 31st December 2008 are no longer be audited centrally by the Scottish Hip Fracture Audit. As a result of the hospitals' success in meeting the 98% hip fracture Time to Theatre target, the Scottish Hip Fracture Audit resource has been transferred to an alternative audit of access to musculoskeletal services in 2009. For the immediate future, no data is available to monitor compliance with the Hip Fracture time to theatre target. Work is ongoing to investigate methods of providing comparable data from routine sources. NHS Boards continue to ensure local delivery of this standard.

Data development

The Diagnostic tests and investigations and A&E departments sections summarise findings from new data collection processes. ISD is continually working with the service to improve the quality and completeness of these data.

Accident and Emergency departments

The current national waiting time standard (in place from 31 December 2007) states that 98% of patients should spend no longer than 4 hours in A&E departments before being admitted, discharged or transferred:

  • During the quarter ending 31 March 2009, of around 380,000 patients attending A&E departments in Scotland, 97.2% of patients were admitted, discharged or transferred within the target time (96.5% in January, 97.3% in February and 97.7% in March).
  • The quality and completeness of A&E data continue to improve. Data are available for core sites from April 2006 and non-core sites from July 2007.
Diagnostic tests and investigations

The national standard in place from 31 December 2007 to 31 March 2009, stated a maximum waiting time of 9 weeks for eight key diagnostic tests and investigations. The current national waiting times standard, in place from 31 March 2009, states that patients should wait no longer than 6 weeks for these key diagnostic tests and investigations.

At 31 March 2009, around 39,000 patients were waiting for these tests and investigations. Of these:

  • No patients were recorded as having been waiting more than 9 weeks. This compares to seven patients at 31 December 2008.
  • 53 (0.1%) patients were recorded as having been waiting more than 6 weeks. This compares to 1,873 (4.8%) at 31 December 2008.
  • Prior to this publication, tables were published at Scotland level only. Commencing from this publication on 26 May 2009, these data will now be shown at NHS Board level.
 


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MAIN CONTACTS:

Laura Dobbie
Senior Information Analyst
0131 275 7694
laura.dobbie@isd.csa.scot.nhs.uk

Alan Finlayson
Programme Principal
0131 275 6271
alan.finlayson@isd.csa.scot.nhs.uk

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PRE-RELEASE ACCESS

Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", ISD are obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access" refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days. Shown below are details of those receiving standard Pre-Release Access and, separately, those receiving extended Pre-Release Access.
 
Standard (five day) Pre-Release Access:
Scottish Government Health Department (Analytical Services Division)
NHS Board Chief Executives
NHS Board Communication leads
 
Extended Pre-Release Access:
Scottish Government Health Department (Analytical Services Division)
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).
 
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HISTORY OF THIS PUBLICATION:

Last Published: 24 February 2009
Next Due: 25 August 2009
Data Available Since: For inpatient / day case and outpatient waiting times, this is the fifth publication of 'New Ways' data and is comparable with the previous publications on 24 February 2009, 27 May 2008, 26 August 2008 and 25 November 2008 respectively. Prior to this, other, incomparable, waiting times data was available back to 1992.


Main contact: Email Laura Dobbie