Typical targets for NHS waiting times are expressed in terms of the percentage of patients seen within a certain time. In my previous report: ‘Is Scotland’s A&E still the best in the UK, in 2016? Is it still the best in the World as it was in 2015?’ at:
Table 1: Percentage of patients spending less than 4 hours in A&E 2015–16
N. Ireland 71.7%
This seems to suggest that NHS Scotland A&E is performing quite a bit (5.4%) better than NHS England but it might actually be the case that it is performing much, much, better than that or even worse (unlikely I know) than that if you looked at the average or median waiting times.
Imagine, in this extreme case to make the point, that nearly all Scotland’s 93.3% were being seen in less than 4 hours but that nearly all were also taking more than 3 hours and that the average or median waiting time was 3.6 hours. Keep imagining and visualise statistics showing that nearly all of the England’s 87.9% were being seen in less than four hours but also that nearly all of them were being seen in less than 1 hour and that the average or median waiting time in England was 0.8 hours. In this scenario, which system performs best? It’s no-brainer, I’d say. NHS England! It’s not of course.
So, targets based on the percentage being seen within a target time are useful but quite limited. Averages or medians would be particularly useful if you wanted to compare two systems. Averages, however, are hard to find. After considerable searching, I found almost no sign of averages or medians. Government, Scottish and UK, sites do not seem to have any such data. I did however stumble on evidence from MSP Alex Neil in the Daily Record and from Health Secretary Shona Robinson, in the Dumbarton Reporter that the average waiting time ‘to start cancer treatment’, in Scotland, is 6 days.
Unable to find average or median waiting times for the same period between the arrival of the GPS referral letter and first diagnostic assessment, in England, I emailed email@example.com on 5th November and awaited a reply to my request for an average or median figure. I got this on the 9th :
‘Hi Professor John,
Unfortunately we don’t have on hands. It has not been published that part of information straightway which is involved with the patient level data.
D for Dumbo you’re wondering? D for grammar exam?
I was, however, able to find a Daily Telegraph article for 2011 suggesting an average of 14 days then in NHS England. The article reported this figure against the background of suggestions that health board were actually advising GPs not to make referrals if they thought patients might not be able to make the appointments within the 14 day target and thus worsen their figures. In 2013, a Huffington Post article made this even more disturbing claim about an English health board:
‘Prof Sir Mike Richards, the chief inspector of hospitals is reported to have said that patients’ lives may have been put at risk so the Trust could give an impression it was meeting waiting list targets.’
I know, this is very very limited but I thought you’d still like to see what I did find.