1 In 8 Patients Waiting Over A Year, Admits Minister

One in eight NHS hospital patients still has to wait more than a year for treatment, the government acknowledged yesterday in its first attempt to tell the full truth about health service queues in England.

A Department of Health analysis of 208,000 people admitted to hospital in March showed 48% were wheeled into the operating theatre within 18 weeks of a GP sending them for hospital diagnosis. But 30% waited more than 30 weeks and 12.4% more than a year.

In a key manifesto pledge at the 2005 general election, the government promised that by December next year all patients would be treated within 18 weeks.

The health minister, Andy Burnham, said the analysis showed the NHS was “firmly on course to achieve the historic goal to end waiting in its 60th anniversary year”. But he acknowledged that the target was the most challenging ever set for the health service. Under successive governments, the NHS measured outpatient and inpatient waiting times separately. The outpatient clock started ticking when a GP made a referral and stopped when the patient went in for a first appointment with a consultant. The maximum delay at this stage is 13 weeks in England.

The inpatient clock started when the consultant decided hospital treatment was needed and stopped when the patient was treated. The maximum inpatient delay is six months. Until now, the NHS did not measure the time patients waited after the first outpatient appointment before going on the inpatient list. This “hidden” delay could last months.

By promising to complete the entire “patient journey” within 18 weeks, the government has begun to expose the hidden waits unknown to NHS managers.

The NHS performs about 4m operations a year. If the March treatment list was typical, about 500,000 of these patients will have waited longer after being referred by a GP. Most of the long waits were for orthopaedic surgery, ophthalmology, gynaecology, ear nose and throat, and general surgery.

Performance varied widely across England. In Swindon and in Brighton less than a quarter of patients were treated within 18 weeks, but in Leicester, where health secretary Patricia Hewitt has her parliamentary constituency, the proportion was 98%. Mr Burnham said all but eight trusts reduced waiting times last year. They were: Barking, Havering and Redbridge; Whipps Cross, London; Peterborough and Stamford foundation trust; Swindon and Marlborough; Moorfields Eye foundation trust, London; Worthing and Southlands; University College London; and Weston Area Healthcare, Somerset.

In December, the department estimated that 35% of patients were treated within 18 weeks. The March census showed this increased to 48%. But officials admitted that the NHS cannot yet track all patient journeys and the figures are provisional.

Some primary care trusts ordered hospitals to go slow in March to avoid overspending. The analysis measured the waits of people who were treated during the month without estimating the extra waiting experienced by those still in the queue.

The shadow health secretary, Andrew Lansley, said the figures revealed “a postcode lottery in access to care”. For many treatments, the 18-week target was not ambitious enough. “On the continent waits of this kind would be regarded as outrageous. But a one-size-fits-all target will distort clinical care and damage the NHS.”

Norman Lamb, the Liberal Democrat health spokesman, said: “Behind the statistics, thousands of sick people are still waiting more than a year for hospital treatment. This is a daily tragedy.”

Niall Dickson, chief executive of the King’s Fund health thinktank, said: “It is a credit to the health service that waiting times have continued to fall steadily at a time of financial pressure.”

NHS waiting times

% NHS patients treated within 18 weeks of GP referral

Bottom 10

Swindon 22%

Brighton & Hove 23%

Mid Essex 25%

Enfield 26%

West Hertfordshire 27%

Hull 29%

Hastings & Rother 29%

Coventry 31%

Medway 31%

Hounslow 32%

Top 10

Leicester City 98%

Solihull Care 94%

South Birmingham 94%

Heart of Birmingham 93%

Leicester County & Rutland 90%

Tower Hamlets 87%

Telford & Wrekin 86%

Leeds 85%

Sandwell 85%

Milton Keynes 73%