Waiting Times

Statistical Publication Notice

26 August 2008

Acute Activity, Waiting Times and Waiting Lists to 30th June 2008 (quarterly and annual data)

INTRODUCTION

Data quality

KEY POINTS

• At 30 June 2008, over 99.9% 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 to measure performance against Scottish Government waiting times standards.
• 99.6% of new outpatients seen and 99.4% of inpatients and day cases treated in quarter ending 30 June 2008 had waited less than 18 weeks.
• In general, relatively small numbers of patients waiting for cardiac and cataract treatment were reported as waiting longer than local targets.
• 2.7% of new outpatients and 14.6% of inpatients and day cases on waiting lists at 30 June 2008 were unavailable for treatment at that date.
• 98.3% of patients attending A&E departments during the month ending 30 June 2008 were seen within 4 hours.
  

INTERPRETATION

• Waiting times information for inpatients, day cases and outpatients are now 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 second 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', 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.
• 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

New outpatients - patients waiting at month end

• The current national waiting time standard, in place from 31 December 2007, states 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 dentist. The latest available information shows that over 99.9% (from a total of around 196,000) had been waiting 18 weeks or less at 30 June 2008.
• The future national waiting times standard, in place from 31 March 2009, is that patients should wait no longer than 15 weeks. 97.1% had been waiting 15 weeks or less at 30 June 2008. This compares to 97.2% for month end 31 March 2008.
• The total number of patients (referred by any source) on waiting lists for a new outpatient appointment at 30 June 2008 was recorded as around 252,000. Of these, 2.7% were unavailable for an appointment on 30 June 2008. This compares to 2.4% at month end 31 March 2008.

New outpatients - patients seen during the quarter

• 99.6% of patients seen (from a total of around 214,000) during the quarter ending 30 June 2008 waited for 18 weeks or less; 89.1% waited 15 weeks or less. This is an increase on quarter end 31 March 2008 figures (99.4% and 85.9% respectively). 
• One half of patients seen at outpatient departments during the quarter ending 30 June 2008 waited 43 days or less (median). This compares to a median of 42 days for quarter end 31 March 2008. 
• The 90th percentile wait indicates the maximum time 9 out of every 10 patients waited. For the quarter ending 30 June 2008 this was 108 days. This is a reduction on the figure for quarter end 31 March 2008 (113 days).
• 90.5% 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 89.9% for quarter end 31 March 2008.

New outpatients - waiting list activity

• During the quarter ending 30 June 2008 around 381,000 patients 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, 4% were removed because they no longer required treatment, 3% were transferred and 6% were removed for other reasons.

Inpatients and day cases - patients waiting at month end

• The current national waiting time standard, in place from 31 December 2007, states that patients should wait no longer than 18 weeks for inpatient or day case treatment. At 30 June 2008, over 99.9% (from a total of around 67,000) had been waiting 18 weeks or less. The future national waiting times standard, in place from 31 March 2009, is that patients should wait no longer than 15 weeks. 97.5% had been waiting 15 weeks or less at 30 June 2008. This is an increase on the month end 31 March 2008 figure (97.0%). 
• The total number on waiting lists for inpatient and day case treatment at 30 June 2008 was recorded as around 67,000. Of these, 14.6% were unavailable for an appointment on 30 June 2008. This compares to 12.0% at month end 31 March 2008.

Inpatients and day cases - patients seen during the quarter

• 99.4% of patients seen (from a total of around 95,000) during the quarter ending 30 June 2008 waited 18 weeks or less; 92.3% waited 15 weeks or less. This shows a consistency with quarter end 31 March 2008 figures for patients waiting 18 weeks or less and an increase for patients waiting 15 weeks and less (90.9%). 
• One half of patients admitted for inpatient and day case treatment during the quarter ending 30 June 2008 waited 33 days or less (median). This compares to a median of 34 days for quarter ending 31 March 2008. 
• The 90th percentile wait indicates the maximum time 9 out of every 10 patients waited. For the quarter ending 30 June 2008 this was 99 days. This is a reduction on the quarter end 31 March 2008 figure (113 days).
• 89.1% 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 89.8% for quarter end 31 March 2008

Inpatients and day cases - waiting list activity

• During the quarter ending 30 June 2008 around 116,000 patients were removed from a waiting list for an inpatient or day case admission. Of these, 82% were removed because they were admitted as planned, 8% were removed because they no longer required treatment, 3% were transferred, 3% were removed because they were referred back to their GP and 4% were removed for other reasons.

'Whole Journey' waiting times for cardiac and cataract

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.

Cardiac - key points

• 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.
• 468 patients were waiting for angiography, 517 for revascularisation, 139 for valve surgery and 702 patients for other cardiac surgery.
• Of the 139 patients waiting for valve surgery, 97.8% were waiting equal to or less than 10 weeks. This compares to 100% at month end 31 March 2008.
• Of the 702 patients waiting for other cardiac surgery, 99.1% were waiting equal to or less than the local target.
• Waiting times data for angiographies and revascularisation are not presented at Scotland level, as they require further work in order to improve reliability.

Cataracts

• The current national waiting time standard states 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 standard of 18 weeks.
• 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.
• Waiting times data for cataract surgery are not presented at Scotland level, as they require further work in order to improve reliability.

Hip fracture

• During the quarter ending 30 June 2008, around 1 350 patients were eligible to comply with the target, of which 97.0% were in surgery within 24 hours of safe operating time. This compares to 97.9% for the quarter ending 31 March 2008.

Data development

Accident and emergency departments

• During the month ending 30 June 2008, 98.3% of patients attending A&E departments in Scotland were seen within the target time. This is the highest performance recorded to date.
• 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

• At the end of June 2008, around 43,400 patients were waiting for these tests and investigations. 2 (0.0%) patients were recorded as having been waiting more than 9 weeks. This compares to 6 at 31 March 2008 and 3,105 at 30 June 2007.

Acute Activity

Provisional high-level figures (the data includes some estimates) show that for the quarter ending 30 June 2008:

• Around 1,175,000 outpatients were seen at consultant clinics. This figure shows an increase of 4.0% when compared to the equivalent quarter in 2007. Over 361,000 of these were new outpatient appointments.
• Almost 2.3 return outpatients were seen for each new outpatient seen, a decrease of 2.6% compared to the quarter ending 30 June 2007.
• There were around 383,000 new A&E attendances, a fall of 1.1% on the equivalent quarter in 2007.
• Almost 106,000 routine inpatients were discharged from hospital, 5.3% more than the equivalent quarter in 2007.
• Around 106,000 day cases were discharged, 5.7% more than the equivalent quarter in 2007.
• Over 133,000 non-routine inpatients were discharged, 2.1% more when compared to the quarter ending 30 June 2007.

Beds

• 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 cases, 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:

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

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

Matthew Armstrong
Principal Information Analyst
0131 275 7487 
matthew.armstrong@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: 27 May 2008
Next Due: 25 November 2008
Data Available Since:  For inpatient / day case and outpatient waiting times, this is the second publication of New Ways data and is comparable with the first publication on 27 May 2008. Prior to this, other, incomparable, waiting times data was available back to 1992. For activity and beds information, some trends are available from April 1998.

Main contact: Alan Finlayson

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