Waiting time targets

Rob Findlay, founder of Gooroo Ltd and a specialist in waiting time dynamics, helps solve an NHS conundrum.

The NHS is in a conundrum. Trusts with a long wait list are fined under the NHS contract if it treats them; or by performance management if it doesn’t.

But there is a solution, albeit a messy one.

From April 2013, the target regime is expected to focus on the waiting list, when 92 % of incomplete pathways must be below 18 weeks.

This year, trusts must tackle the 18-week backlog but by doing so they will probably breach the admitted and non-admitted targets which live on - zombie-like - in the NHS Contract.

In operational terms, those trusts with an 18-week backlog should treat long-waiting patients, a move that is consistent with the four principles of good waiting list management of: treat more urgent patients more quickly; treat patients with similar priority broadly in turn; keep the longest waits to a reasonable level; don’t waste the available capacity.

In planning terms, it is more difficult because there are the zombie targets (based on patients as they are being treated) and the new ones (based on patients who are still waiting) to juggle.

Resolving this is easier – trusts should plan activity and capacity to achieve the more difficult zombie targets.

If all goes well, then the targets muddle should only last for a year, thus freeing up trusts to focus on stopping the long-wait backlogs from building up in the first place.

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