This topic covers statistical outputs that are used to measure and monitor waiting times for NHS treatment and other aspects of access to treatment.
Publications
A&E activity; total time spent in A&E from arrival to admission, discharge or transfer and waiting for emergency admission through A&E.
This publication provides Accident and Emergency (A&E) attendance data. It details records of attendances at major A&E departments, single specialty A&E departments, minor injury units and walk in centres in England.
Acute Hospital Activity
Statistical release published by the Scottish Government detailing cancer waiting-time statistics for urgently-referred patients by tumour site and NHS board.
Delayed Discharges in NHSScotland
Monthly collection of data covering those patients on a Direct Access audiology pathway.
Provides information pertaining to the Governments key priorities for improving routine access to GP services in evenings and at weekends.
This statistical bulletin presents information on hearing aid assessments and re-assessments by audiologists in Northern Ireland. Information has been derived from the quarterly collection AUD1 and monitors information on both adults and children fitted and assessed for hearing aids during the quarter, complaints received, and cost of hearing aids issued. In addition, the collection monitors complete and incomplete waits for assessment during the quarter and the length of time patients were waiting or had waited following referral to an audiologist (specified time bands).
Provides data on Cancer waiting times for Welsh NHS Trusts.
This Statistical Release shows information on waiting times for specified diagnostic and therapy service for the NHS in Wales.
Diagnostic test waiting.
Waiting times or waiting list statistics.
Admission events.
Referral to treatment waiting.
This Statistical Release presents data on the number of weeks that residents of Wales have been waiting for inpatient/day-case admission and outpatient appointments.
This Statistical Release gives information on the total time waited from referral by a GP or other medical practitioner to hospital treatment in the NHS in Wales.
This Statistical Release presents data on time spent in A&E departments of NHS Trusts within Wales
Waiting Times and Waiting Lists
Cancer waiting.
Overview
The content of this topic includes statistics that measure and monitor the waiting times for NHS treatment and other aspects of access to NHS treatment and services. Many of these statistics are used by central government and by the NHS to assess the performance of the NHS in meeting patient needs. Some of these patient needs are expressed as targets or standards, both national and local.
These are examples of content:
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Time Waited from GP Referral to Treatment (this ‘whole patient pathway’ output is used to monitor the 18 week waiting target in England)
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Waiting Times for ‘Stages of NHS Treatment’ such as:
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Inpatient Treatment (from decision to admit to admission)
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Outpatient Appointment (from GP referral to consultant led appointment)
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Diagnostic Test (waiting time for any diagnostic test)
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Waiting Times for Suspected Cancer patients
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Time spent in Accident and Emergency units
Technical Data
Referral to treatment (RTT) time waited
RTT data are collected from English Primary Care Trusts on a responsible population basis and from NHS Trusts on a provider basis.
The RTT data measure referral to treatment (RTT) times in weeks, split by treatment function. The length of the RTT period is reported for patients whose 18 week clock stopped during the month.
The return includes all patients whose 18 week clock stopped at any point in the reporting period. A column has been provided to enter data for patients whose length of RTT period is unknown, that is, patients who have had a clock stop during the month but where the clock start date is not known.
For non-admitted patients, the RTT time is measured on an unadjusted basis - from the date the 18 week clock starts to the date that the 18 week clock stops, as detailed in DSCN 17/2006. For admitted patients, the RTT time is measured on an adjusted basis - from the date the 18 week clock starts to the date that the 18 week clock stops, allowing for legitimate pauses as described in the above 18 Weeks Rules Suite and outlined in the Operating Framework for 2008/09 paragraphs 2.24 to 2.28.
The Department of Health published the 18 Weeks Rules Suite on 28 November 2007. The documents can be found at on the 18 weeks website.
The rules for the data collection are based on those set out in the rules documents.
The data collection is in three parts:
Part 1a: Completed pathways – admitted
Part 1b: Completed pathways – non-admitted
Part 2 : Incomplete pathways
Inpatient and Outpatient waiting times
Inpatient waiting times are measured from decision to admit by a consultant to admission, and include both ordinary and day case admissions.
They exclude:
- patients admitted as emergency cases
- patients undergoing a planned programme of treatment, for example a series of admissions for chemotherapy
- expectant mothers booked for confinement
- patients already in hospital
- patients who are temporarily suspended from waiting lists for social reasons or because they are known to be not medically ready for treatment
Outpatient waiting times are measured from referral from General Practitioner (GP) to first consultant led outpatient appointment. Waiting times include patients who were referred by a GP whether medical or dental. They exclude:
- patients referred by consultants and other health professionals
- self referrals and attendances at 'drop in' clinics
- referrals resulting in ward attendances for nursing care
- referrals initiated by the consultant in charge of the clinic
Both inpatient and outpatient statistics show the number of patients still waiting at the end of the period, split by how long they have waited. The waiting times are shown in weekly time bands.
Statistics are collated monthly from NHS Trusts and Primary Care Trusts on an aggregate level and are produced on both a provider and a commissioner basis. Provider figures include patients waiting for treatment at NHS Trusts in England, whereas commissioner figures include patients who are the responsibility of English PCTs, regardless of where they are waiting. Therefore, as provider figures include non-English patients, commissioner figures should be used to assess performance against English NHS standards.
Median waiting times are calculated from aggregate data, rather than patient level data, and therefore are only estimates of the position on average waits. They represent the median waiting time for patients still waiting for admission (or for first outpatient appointment) at the end of the month.
Please see below for more information on other areas:
Technical Definitions for Diagnostics statistics.
More information on Cancer Waiting Times are available on the Performance website and the Department of Health website.
Glossary
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Admitted patient
These are pathways where the patient required treatment through being admitted to hospital, either as an inpatient or a daycase.
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Cancer waiting times
Waiting times of patients with suspected cancer and those subsequently diagnosed with cancer. Measures are the wait from urgent GP referral to first outpatient appointment for all patients with suspected cancer; the wait from clinical diagnosis to treatment for all cancer; and the wait from urgent GP referral to treatment for all cancers.
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Diagnostic Census
A quarterly publication collecting details of waiting times for diagnostic tests not published monthly.
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Diagnostic test
A test or procedure used to identify a person’s disease or condition and which allows a medical diagnosis to be made. In contrast, a ‘therapeutic procedure’ is defined as a procedure which involves actual treatment of a person’s disease, condition or injury. Tests carried out as part of national screening programmes do not count as a diagnostics test/procedure for the purposes of these figures.
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Diagnostic tests (15 key)
The set of diagnostic tests published on a monthly basis. The tests were chosen as they represented the high volume and long waits that were seen as the biggest problem. They are as follows: Magnetic Resonance Imaging, Computer Tomography, Non-obstetric ultrasound, Barium Enema, DEXA Scan, Audiology assessment, Cardiology - echocardiography, Cardiology - electrophysiology, Neurophysiology - peripheral neurophysiology, Respiratory physiology - sleep studies, Urodynamics - pressures & flows, Colonoscopy, Flexi sigmoidoscopy, Cystoscopy, and Gastroscopy.
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Inpatient waiting time
Waiting time from decision to admit by a consultant to admission into hospital. Patient can be admitted as an ordinary inpatient admission or a day case. Emergency admissions are excluded.
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Non-admitted patient
A pathway that results in a clock stop for treatment that does not require an admission or for ‘non-treatment’.
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Outpatient waiting time
Waiting time from receipt of referral from General Practitioner to first consultant led outpatient appointment.
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Primary Care Trusts
Primary Care Trusts (PCTs) covering all parts of England receive budgets directly from the Department. Since April 2002, PCTs have taken control of local health care while Strategic Health Authorities monitor performance and standards.
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Referral to treatment
Waiting time from initial referral, which initiates a clock start, leading up to the start of first definitive treatment or other 18 week clock stop point.
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Time of arrival in A&E
The time of arrival is recorded by the clinician (nurse or doctor) carrying out initial triage/assessment or A&E reception whichever is earlier. For ambulance cases, arrival time is when handover occurs or 15 minutes after the ambulance arrives at A&E, whichever is earlier.
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Time of departure from A&E
Total time in the department ends when the patient is admitted, transferred, or discharged home.
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Total time in A&E
Total time spent in Accident and Emergency from the time that the patient arrives in A&E to when the patient leaves the department on admission, transfer to another agency or organisation or discharge.
Contact Details
For statistical enquiries about this topic, please contact:
Knowledge and Intelligence
Email: unify2@dh.gsi.gov.uk
Telephone: +44 (0) 1132 545214
Knowledge and Intelligence Room 4E60 Quarry House Quarry Hill Leeds LS2 7UE
