Many UK patients wait over a year for treatment

The UK government has today announced another increase in the number of patients who have been treated within the 18-week target from referral to treatment (RTT). The latest count, from October 2007, shows 59.9 percent received treatment within the targeted time.

But this conceals the very serious problems that remain: 713,513 (or 18.1 percent) of elective patients still waiting for treatment in October 2007 have been waiting longer than 36 weeks, with 387,152 (9.8 percent) of these having waited over a year.

There is a massive postcode lottery. Just 33 percent of patients treated in October 2007 in Hastings and Rother Primary Care Trust (PCT) were treated within 18 weeks, compared with 82 percent in Blackpool PCT and Telford & Wrekin PCT.

The national picture

Performance has been steadily improving: in January 2007, only 47 per cent of admitted patients were making it through the pathway within 18 weeks; in April it was 51 per cent; in June it was 54 percent and in September it was 57.1 percent. Now it stands at 59.1 percent.

However, current rates of improvement will not be enough to meet the target that 100 per cent of patients be treated within 18 weeks by December 2008.

The improvement between September and October is consistent with the linear trend identified in the recent report Why are we waiting?, released by the independent social policy think tank Civitas earlier this month. On this basis, only 77 percent of admitted patients will be treated within 18 weeks by December. The interim benchmark of 85 pe cent by March looks simply utopian and, perhaps unsurprisingly, the government recently revised the December 2008 target down to 90 percent.

More difficult still

While it's true improvement may accelerate over time - as more trusts get the data right, referral management centres become more effective and more care pathways have been redesigned - it is equally possible that the problem will be revealed as more intractable than it appears. In many cases meeting the 18 week target will involve much more than just marginal improvements.

Very long waits

A closer look at the Department of Health's RTT statistics released today shows many patients are still waiting a very long time.

For admitted patients who received treatment (whose 'RTT clock' stopped) in October 2007: 21,086 (or 8.0 per cent of patients where data is recorded) had still waited over a year for treatment; while 37,302 (14.0 percent) had still waited over 36 weeks.

These are higher numbers than in September, where the figures were 19,441 and 33,665 respectively.

Only 38 percent receiving trauma and orthopaedic care were treated within 18 weeks, yet is in the highest demand of all electives.

For 16.3 percent of patients, data is still not available. We do not know how long they waited.

For patients who were still waiting for treatment as of October 2007: Just 59.3 percent are projected to be treated within 18 weeks of referral (less than the 59.9 per cent of those treated in October).

713,513 (or 18.1 percent) have currently been waiting longer than 36 weeks and 387,152 (9.8 percent) have currently been waiting over a year.

The figure for 36 weeks is substantially larger than that for September when 665,895 (or 16.7 percent) of patients waiting had been doing so for longer than this time.

Despite only being one part of the pathway, 30, 832 were still waiting over 26 weeks just to receive diagnostics, of which 16,551 had been waiting over a year.

Many of these are in particular PCTs; for example 97.1 percent of audiology patients in Herefordshire PCT waited longer than 13 weeks, compared with none in Worcestershire PCT, despite the fact