The NHS in Scotland has made significant progress towards meeting waiting time targets over recent years but future targets are likely to be challenging.
An Audit Scotland report published today, Tackling Waiting Times in the NHS in Scotland, finds that since 2001 the health service has made good progress in reducing the longest waits for inpatient, day case and outpatient care for people with waiting time guarantees.
Deputy Auditor General Caroline Gardner said: ‘The NHS in Scotland has made substantial progress in tackling the longest waits but faces pressures that will make future targets challenging to meet. It needs to do more to develop approaches that work across the whole health and community care system to tackle waiting times. We also suggest that the Golden Jubilee National Hospital could be used more efficiently.’
The report says that the number of people with guarantees waiting longer than six months for inpatient or day case treatment has fallen from 11,573 in March 2001 to 1,249 in September 2005, a drop of 89 per cent.
The NHS in Scotland has also made good progress towards meeting outpatient waiting time targets. The total number of people with guarantees waiting over six months for their first appointment fell from 53,579 to 11,854 between September 2004 and September 2005, a decrease of 78 per cent.
However the total number of patients waiting for inpatient and day case treatment has changed little in recent years and the number of patients with Availability Status Code (ASC) has increased. Patients with ASCs do not have waiting time guarantees.
At September 2005, there were 35,048 patients with an ASC waiting for inpatient or day case treatment, up from 28,349 in June 2003. Two thirds of these patients have been waiting for longer than six months.
These trends, as well the abolition of ASCs at the end of 2007 and a reduction in the maximum waiting time from six months to 18 weeks, suggest that meeting future targets will be challenging.
The report says the NHS needs to work more on developing approaches across the whole health and community care system to tackle waiting times. The Scottish Executive should review the balance of its funding between the longer-term development of such whole system approaches and system redesign, and shorter-term approaches to meet current targets.
The report suggests there is potential to involve patients more in decisions about where they are treated and that this could help cut waiting times. A survey undertaken for the report found that two-thirds of patients currently waiting would travel for earlier treatment, but that only about five per cent have been offered this.
Audit Scotland also suggests that the NHS could use the Golden Jubilee National Hospital in Clydebank more efficiently. The hospital offers care to patients from all over Scotland to reduce the longest waiting times.
The report says the GJNH and NHS boards need to work more closely together to better plan activity at the hospital. The hospital exceeds its total activity targets, but in some specialities not all the capacity is used. This, along with factors such as the way it pays doctors, means its costs are high compared with the rest of the NHS in Scotland.