NHS has improved management and scrutiny of waiting lists

The NHS and Scottish Government have improved how they manage, monitor and scrutinise waiting lists, in response to recommendations from Audit Scotland, the Scottish Parliament and internal auditors.

Audit Scotland today reports on progress by the NHS in monitoring how they manage waiting lists and improving audit trails. This updates progress since Audit Scotland reported in February on a Scotland-wide review of waiting list management following manipulation of waiting lists at NHS Lothian.

Audit Scotland, NHS boards' internal auditors and the Parliament's Public Audit Committee carried out investigations and inquiries during 2012 and 2013 and made recommendations to the government and health service.

Today's report, Management of patients on NHS waiting lists: audit update, says:

  • The Scottish Government and NHS have worked to implement recommendations by Audit Scotland, the Parliament's Public Audit Committee and internal auditors. NHS boards are implementing better controls and audit trails, and have improved the information used for monitoring and reporting
  • The use of unavailability codes – which was highlighted in the investigations into NHS Lothian – has continued to fall, following a trend reported in February
  • Boards are also using new codes which should allow them to better identify problems with their ability to treat patients locally. February's report said better use of codes could help identify pressures in the system around meeting waiting times targets
  • It has taken time to update IT systems to take account of a new 12-week treatment time guarantee and audit recommendations. As a result, there is less national information on waiting times publicly available. The Scottish Government and the NHS are working to resolve this and fill gaps in the information needed for monitoring
  • Most NHS boards are treating patients within 18 weeks of referral to hospital, but the new 12-week guarantee for inpatients is challenging. Only three boards have met this target each month since the guarantee was introduced in October 2012.

Auditor General for Scotland, Caroline Gardner, said:

"Waiting times are very important to patients and are a major performance target for the health service. Earlier this year we made a number of recommendations aimed at improving the management of NHS waiting lists. The Parliament’s Public Audit Committee and boards’ internal auditors also made further recommendations. Since then the health service and the Scottish Government have done a lot of work to improve how they manage, monitor and scrutinise waiting lists. It is also encouraging to see the introduction of new patient unavailability codes that should help NHS boards identify problems with capacity and pressures in the system."