Waiting Times

Statistical Publication Notice

27 May 2008

Acute Activity, Waiting Times and Waiting Lists to 31 March 2008 (quarterly and annual data)

INTRODUCTION

KEY POINTS

• at 31 March 2008, 0.2% of new outpatients and 0.1% of inpatients and day cases were waiting longer than the 18 week national standard [these figures are expected to reduce following revision by some NHS Boards]
• 0.6% of new outpatients seen and 0.7% of inpatients and day cases treated in quarter ending 31 March 2008 had waited longer than the 18 week national standard [these figures are expected to reduce following revision by some NHS Boards]
• small numbers of patients waiting for cardiac and cataract treatment were reported as waiting longer than local targets [these figures are expected to reduce following revision by some NHS Boards]
• 1.9% of new outpatients and 10.6% of inpatients and day cases on waiting lists at 31 March 2008 were unavailable for treatment at that date
• 98% of patients attending A&E departments during quarter ending 31 March 2008 were seen within 4 hours
• some of the published statistics show marked variation between boards

INTERPRETATION

• This is the first 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 have previously been excluded from national standards for waiting are now included, taking 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’, some 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 sources of waiting times data, 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.

DETAILED FINDINGS

• The total number of patients (referred by any source) on waiting lists for a new outpatient appointment at 31 March 2008 was recorded as 221 000. Of this total, 1.9% were unavailable for an appointment on 31 March 2008.
• The current national waiting time standard, in place from end December 2007, is that patients should wait no longer than 18 weeks to attend a consultant led new outpatient clinic after being referred by their doctor or dentist. The latest available information shows that 0.2% had been waiting more than 18 weeks at 31 March 2008. [this figure is expected to reduce following revision by some NHS Boards – see footnotes of this table for more details]
• The future national waiting times standard, in place from 31 March 2009, is that patients should wait no longer than 15 weeks. 3.2% had been waiting more than 15 weeks at 31 March 2008.

• The 'typical' waiting time, as measured by the median wait, of patients seen at outpatient departments during the quarter ending 31 March 2008 was 42 days. The 90th percentile wait indicates the maximum time 9 out of every 10 patients waited. For the quarter ending 31 March 2008 this was 113 days.
• 0.6% of patients seen (from a total of approximately 190 000) during the quarter ending 31 March 2008 waited for longer than 18 weeks [this figure is expected to reduce following revision by some NHS Boards – see footnotes of this table for more details]; 14.3% waited for longer than 15 weeks.
• 91% of patients experienced no delay to their health care as a result of patient cancellation, non-attendance or medical or social unavailability.

• During the quarter ending 31 March 2008:
  • 81% of patients removed from a waiting list for a new outpatient appointment were removed because they had attended an appointment. 6% were removed because they were referred back to their GP, 4% were removed because they no longer required treatment and 9% removed for other reasons.

• The total number on waiting lists for inpatient and day case treatment at 31 March 2008 was recorded as 62 600. Of this total, 10.6% were unavailable for an appointment on 31 March 2008.
• The current national waiting time standard, in place from end December 2007, is that patients should wait no longer than 18 weeks for inpatient or day case treatment. At 31 March 2008, 0.1% had been waiting more than 18 weeks. [this figure is expected to reduce following revision by some NHS Boards – see footnotes of this table for more details ]
• The future national waiting times standard, in place from 31 March 2009, is that patients should wait no longer than 15 weeks. 3.2% had been waiting more than 15 weeks at 31 March 2008.

• The 'typical' waiting time, as measured by the median wait, of patients admitted for inpatient and day case treatment during the quarter ending 31 March 2008 was 34 days. The 90th percentile wait indicates the maximum time 9 out of every 10 patients waited. For the quarter ending 31 March 2008 this was 103 days.
• 0.7% of patients seen (from a total of 87 800) during the quarter ending 31 March 2008 waited for longer than 18 weeks [this figure is expected to reduce following revision by some NHS Boards - see footnotes of this table for more details ]; 9.1% waited for longer than 15 weeks
• 90% of patients experienced no delay to their health care as a result of patient cancellation, non-attendance or medical or social unavailability.

• During the quarter ending 31 March 2008:
  • 83% of patients removed from a waiting list for a new outpatient appointment were removed because they had attended an appointment. 2% were removed because they were referred back to their GP, 8% were removed because they no longer required treatment and 7% were removed for other reasons.

• Referral to treatment targets for cataract surgery and cardiac treatment have been introduced and are in place from end 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.

Whole journey - Cardiac

• The current national waiting time standards are 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.
  Systems are not yet in place to capture total patient journey information so progress towards this target is published by reporting on the component parts – assessment, investigation and intervention - of the journey. 
• 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.
• 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.
• At 31 March 2008:
  • 439 patients were waiting for angiography, of which 2.3% were waiting longer than the local target [this figure is expected to reduce following revision by some NHS Boards - see footnotes of this table for more details ]
  • 338 patients were waiting for revascularisation, of which 1.2% were waiting for more than 10 weeks [this figure is expected to reduce following revision by some NHS Boards – see footnotes of this table for more details ]
  • 98 patients were waiting for valve surgery, of which 2.0% were waiting longer than 10 weeks [this figure is expected to reduce following revision by some NHS Boards – see footnotes of this table for more details ]

Whole Journey - Cataracts

• The current national waiting time standards is that the maximum wait from referral by a GP or optometrist to surgery should be 18 weeks.  Systems are not yet in place to capture total patient journey information so progress towards this target is published by reporting on the component parts – assessment and surgery - of the journey.
• 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 target of 18 weeks.
• At 31 March 2008:
  • Statistics on patients waiting for an outpatient assessment for cataract will not be published at this time as they require some further work in order to improve their reliability
  • 3300 patients were waiting for cataract surgery

• The current national standard, in place from end December 2007, is 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.
• During the quarter ending March 2008, there were almost 1 600 patients eligible to comply with the target, of which 98% were in surgery within 24 hours of safe operating time. This compares to 96% for the quarter ending 31 December 2007.

Diagnostic tests and investigations

• The current national standard, in place from end December 2007, is for a maximum waiting time of 9 weeks for eight key diagnostic tests and investigations.
• At the end of March 2008, 43 000 patients were waiting for these tests and investigations. 6 (0%) patients were recorded as having been waiting more than 9 weeks, down 104 (95%) from 31 December 2007 and 2 146 (100%) down from 31 March 2007.

Accident and emergency departments

• The current national waiting time standard (in place from end December 2007) is that 98% of patients should spend no longer than 4 hours in A&E departments before being admitted, discharged or transferred.
• The quality and completeness of A&E data continue to improve.  Data is available for A&E non-core sites for the period from July 2007 to March 2008 and is presented alongside core site data from April 2006 to March 2008.
• The information shows that, during the quarter ending 31 March 2008, 98% of patients attending A&E departments in Scotland were seen within this target time. This compares to 97% for the quarter ending 31 December 2007. Earlier figures, when only core site data were available, showed 92% for the quarter ending 31 March 2007.  

Acute Activity

• Provisional high-level figures (the data includes some estimates) show that for the quarter ending 31 March 2008:
  • 1 120 000 outpatients were seen at consultant clinics. This figure is stable when compared to the equivalent quarter in 2007. 344 000 of these were new outpatient appointments.
  • 2.1 return outpatients were seen for each new outpatient seen, a fall of 6% compared to the quarter ending 31 March 2007.
  • There were 367 000 new A&E attendances, an increase of 4% on the equivalent quarter in 2007
  • 101 000 routine inpatients were admitted, 5% more than the equivalent quarter in 2007
  • 102 000 day cases were admitted, representing no change from the equivalent quarter in 2007
  • 129 000 non-routine inpatients were admitted, little changed when compared to the quarter ending 31 March 2007.
• More detailed, annual information on outpatient activity broken down to individual clinical specialties to the year ending 31 March 2007 has been refreshed in this update.

• Figures for the year ending 31 March 2008 show a slight decrease in the average number of available staffed beds in acute specialties to 17 300, compared to 17 500 in the year ending 31 March 2007.  This decrease is in line with changing clinical practice, and the development of techniques that allow faster recovery leading to shorter lengths of stay. The growth in day case surgery, where patients occupy a hospital bed for one day or less, and improvements in treating patients in a primary care setting contribute to these trends.
• The occupancy rate of acute beds has been fairly constant over the last eight years at between 81-83%.

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MAIN CONTACTS:

Catriona Haddow
Senior Information Analyst
0131 275 6341
catriona.haddow@isd.csa.scot.nhs.uk
Waiting Times

Philip Johnston
Interim Programme Principal
0131 275 6427
philip.johnston@isd.csa.scot.nhs.uk
Waiting Times

Richard Hunter
Senior Information Analyst
0131 275 6957
richard.hunter@isd.csa.scot.nhs.uk
Inpatient, Day Case and Outpatient Activity

Tracey Cromwell
Senior Information Analyst
0131 275 6179
tracey.cromwell@isd.csa.scot.nhs.uk
Beds

PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

HISTORY OF THIS PUBLICATION:

Last Published: 26 February 2008
Next Due: 26 Aug 2008
Data Avaliable Since: For inpatient/day case and outpatient waiting times, this is the first publication. For activity and beds information, some trends are available from April 1997.

Main contact: Catriona Haddow

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