NHS England has failed to ensure that the waiting-time data which it publishes based on information provided by hospital trusts is consistent, complete and accurate, say MPs.
A National Audit Office (NAO) review of cases at seven trusts has found that waiting lists for nearly a third of cases were not supported by documented evidence, and that a further 26% “were simply wrong,” reports the House of Commons Public Accounts Committee (PAC), and it says that this data should be independently audited.
NHS England’s guidance on the management of waiting times is complex, and this allows trusts some flexibility in how they manage waiting times. However, it also creates unintended consequences such as variations between trusts in the number of cancellations they allow patients to make before referring them back to their GP, thereby restarting the waiting-time clock. These differences reduce the comparability of trusts’ waiting times, says PAC.
Nor is the current regime of financial penalties for trusts that do not achieve the waiting-time standards being used to drive improved performance, the MPs add.
“If patients cannot be confident of accurate comparable data on the performance of hospitals they cannot exercise choice. Both GPs and their patients need reliable and comparable information about the waiting-time performance of individual trusts,” said PAC chair Margaret Hodge MP.
“Furthermore, patients do not fully understand their rights and responsibilities. It should be a lot easier for patients to interact with hospitals and understand when they will see a consultant, but individual hospital policies on access to treatment are often out-of-date and not publicly available,” said Lady Hodge, who is Labour MP for Barking.
The MPs also find that annual savings of up to £51 million through use of the online Choose and Book appointment system are being missed. Choose and Book cost £356 million to March 2012, but it has had “a chequered history” and is underused by both patients and healthcare professionals; not all hospital appointment slots are available to be booked on the system and only half of all possible GP-to-first outpatient referrals are booked using it.
The Department of Health is aiming for Choose and Book’s replacement, e-Referrals, to be used for all referrals within the next five years, sooner if possible, and this should reduce the number of data errors and allow patients to track and manage their hospital appointments.
“However, given the difficulty NHS England has had in getting GPs and others to use Choose and Book, we are sceptical about its ability to achieve full utilisation of e-Referrals,” says PAC.