Statistical press notice - NHS inpatient and outpatient waiting times figures 29th February 2008

Inpatient Waiting times

* The number of patients, for whom English commissioners are responsible, waiting over the 26 weeks standard at the end of February 2008 was 74. Of these 74, 4 were English residents waiting in Welsh hospitals.

* The number of patients, for whom English commissioners are responsible, waiting over 20 weeks at the end of February 2008 was 5,500, an increase of 100 (2.2%) from January 2008, but a fall of 34,600 (86.2%) from February 2007.

* The number of patients, for whom English commissioners are responsible, waiting over 13 weeks at the end of February 2008 was 45,900, a decrease of 7,200 (13.5%) from January 2008, and a fall of 120,700 (72.4%) from February 2007.

* The percentage of patients waiting under 13 weeks was 91.6%, compared to 90.8% in January 2008 and 77.1% in February 2007.  The median waiting time of those still waiting at the end of February

2008 was 4.2 weeks.

Outpatient Waiting times

* The number of patients, for whom English commissioners are responsible, waiting over the 13 weeks standard for a first outpatient appointment following GP referral at the end of February

2008 was 113. Of these 113, 46 were English residents waiting in Welsh hospitals.

* The number of patients, for whom English commissioners are responsible, waiting over 11 weeks at the end of February 2008 was 1,600, a decrease of 300 (16.4%) from January 2008, and a fall of 15,300 (90.6%) from February 2007.

* The number of patients, for whom English commissioners are responsible, waiting over 8 weeks at the end of February 2008 was 14,700, a decrease of 15,200 (50.8%) from January 2008, and a fall of 69,200 (82.4%) from February 2007.

* The percentage of patients waiting under 8 weeks was 98.0%, compared to 95.8% in January 2008 and 91.1% in February 2007. The median waiting time of those still waiting at the end of February

2008 was 2.2 weeks.

Inpatient Waiting Times

Table 1: Inpatient waiting list by time band - February 2005 to February 2008, England (Commissioner based)

Table 2: Proportion of inpatient waiting lists by time band - February 2005 to February 2008, England (Commissioner based)

Waiting List

Table 3: Inpatient waiting lists - February 2005 to February 2008, England

Outpatient waiting times

Table 4: Patients waiting for 1st consultant led outpatient appointment following GP referral - February 2005 to February 2008, England (Commissioner based)

Table 5: Proportion of patients waiting for 1st consultant led outpatient appointment following GP referral by timeband - February

2005 to February 2008, England (Commissioner based)

Revisions

This month, we are publishing revisions to monthly data received during the past 12 months.  These mainly relate to notifications of additional breaches, from NHS Trusts and PCTs, of waiting times standards made after the routine publication of monthly figures.

These are predominately due to administrative errors in NHS Trusts, with some of the breaches covering a number of month ends.

These revisions cover the period April 2006 to January 2008, and the impact on the number of breaches of the standards are shown in Table

6 below.

Table 6: Impact of revisions on previously published breaches of inpatient and outpatient waiting times standards

Statistical Notes

1. Inpatient waiting times

Waiting times information is collected from English Primary Care Trusts on a responsible population basis (see note on next page) and from NHS Trusts on a provider basis.

In interpreting the figures it should be noted that about half of patients (not including live babies) treated in hospitals are emergency cases and do not come from the waiting lists.

This publication contains waiting list information on patients who are waiting to be admitted for treatment either as a day case or ordinary admission. It does not include:

* patients admitted as emergency cases

* outpatients

* patients undergoing a planned programme of treatment e.g. a series of admissions for chemotherapy

* expectant mothers booked for confinement

* patients already in hospital but included on other waiting lists

* patients who are temporarily suspended from waiting lists for social reasons or because they are known to be not medically ready for treatment

Waiting times begin from the date the clinician decided to admit the patient. Patients subsequently offered a date but unable to attend have their waiting times calculated from the most recent date offered. These are known as self-deferred cases and are included in the total waiting.

The tables incorporate all returns and amendments received from Primary Care Trusts and NHS Trusts up to 2nd April 2008.

2. Outpatient waiting times

This publication relates to patients referred by a GP (medical or

dental) for a consultant led first outpatient appointment. It does not include:

* patients referred by consultants and other health professionals;

* self referrals and attendances at 'drop in' clinics;

* referrals resulting in ward attendances for nursing care;

* referrals initiated by the consultant in charge of the clinic.

Waiting times begin from the receipt of a GP referral and end on the date of the 1st outpatient appointment.

3. Provider and Commissioner based lists

There are fundamental differences in coverage between commissioner based and provider based information. Commissioner based returns exclude all patients living outside England and all privately funded patients waiting for treatment in NHS hospitals.  However they do include NHS funded patients, living in England, who are waiting for treatment in Scotland, Wales and Northern Ireland, abroad, and at private hospitals; these patients are not included in the corresponding hospital based returns.  Historically there has been a 1% to 3% difference in the overall size of the waiting lists reported for NHS provider trusts and English residents, the trust-based figure being the larger.

The differences are summarised in the diagram below:

Commissioner based returns reflect responsible based populations, which is defined as:

Responsible Population:

* all those patients resident within the PCT boundary; plus

* all patients registered with GPs who are members of the PCT, but are resident in another PCT; minus

* All patients resident in the PCT, but registered with a GP who is a member of another PCT

4. Current standards for NHS waiting times

Since December 2005, the following standards have been in place for NHS waiting times

* Maximum of 26 weeks for inpatient admission

* Maximum of 13 weeks for 1st outpatient appointment following GP referral

The NHS Improvement Plan, published in July 2004, stated "By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment". To monitor this new target, the Department of Health now also measures referral to treatment (RTT) times.  This information is published monthly and can be found at the following address

http://www.performance.doh.gov.uk/rtt/

5. Note on median waits

Median waiting times are calculated from aggregate data, rather than patient level data, and therefore are only estimates of the position on average waits.  They represent the median waiting time for patients still waiting for admission (or for 1st outpatient

appointment) at the end of the month.

The introduction of weekly timebands in April 2006 has enabled a more precise calculation of the median waiting time, whilst using the same methodology.  Between April 2004 and March 2006, data were collected in monthly timebands, and prior to this in 3 monthly timebands.  As the latest figures are calculated from weekly timebands (and more accurate), they are not strictly comparable to previous years.

6. Revisions

Revisions to previous month's data are made in line with the Department of Health's revisions protocol for performance monitoring data.  A copy of the protocol is attached at Annex A.  Future revisions will be made on a 6 monthly cycle, usually in June and December.

Additional Information

Full details of waiting lists and times for individual organisations are available from the address below.

Knowledge and Intelligence

Department of Health

Room 4E60

Quarry House

Quarry Hill

Leeds LS2 7UE

Email: Unify2@dh.gsi.gov.uk

Annex A - Data Revisions Policy for NHS Performance Monitoring Data

This revision protocol relates to the NHS performance monitoring data collected and disseminated by the Knowledge and Intelligence (K&I) team in the Department of Health. All data collected may be revised, however, the range of published information covered by this policy is shown in the list below. This policy is compatible with the Departmental compliance statement with the National Statistics Code of Practice and Protocols, and with the National Statistics protocol on Revisions.

Dissemination:

The publication of scheduled revised data will be via a statistical press notice every 6 months, released in line with the Department's release policy. Revisions to individual trusts and PCTs will be reflected in the England and SHAs' totals, and the impact on previously published data will be summarised on release.

Explanations for any revisions will be made available on request

Timing:

We will publish significant revisions to the data on a six monthly basis to dates that will be included in the DH Statistics 12-month publication plan.  However, we reserve the right to make unscheduled changes if necessary.

http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/CodeOfPractice/DH_4016423

Any significant revisions received after the revision period has closed, ie 48 hours before publication, will generally not be disseminated until the next scheduled revision.

Historic data:

Revisions will relate usually to the 6 months prior to the revisions publication date. In exceptional circumstances revisions will go further back, if not doing so would materially distort the historical time series.

Decisions about revisions:

DH statisticians reserve the right to refuse any revisions that do not make material differences to datasets.

Final decisions about publishing revised data will be taken after consultations with senior professional DH analysts. The normal pre-release procedure will apply to revisions.

Process for submitting revisions

Revision requests should be made to Unify2@dh.gsi.gov.uk, and more detailed guidance for NHS organisations will be posted on the Unify2 site itself.

NHS performance monitoring data produced by Department of Health subject to scheduled revisions