NHS Borders waiting lists ‘effective and fair’, says report

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NHS Borders chiefs have welcomes a report which states that waiting times are “operating in a controlled manner.” However, some improvements have been recommended.

NHS waiting lists were given the once over by Audit Scotland after it was discovered in 2011 that NHS Lothian had been manipulating their waiting list figures.

An audit of NHS Borders waiting times carried out on their own behalf by Price Watershouse Coopers found the board’s waiting times to be “operating in a controlled manner” with no inappropriate amendments or contraventions of waiting times policies.

Jane Davidson, chief operating officer with NHS Borders, said: “This is a very welcome report and confirms that NHS Borders is operating effectively and fairly.

“The report found many areas of good practice but did make some recommendations for improvement, most of which will help us to use our electronic system to more closely monitor our interaction and dialogue with our patients.

“The review process was very thorough and underscores our commitment to providing a safe and efficient service as we strive to improve the quality of our care for patients.”

After completing their scrutiny of waiting lists across Scotland’s NHS boards, Auditor General for Scotland, Caroline Gardner, said: “The management and scrutiny of the waiting list systems have not been good enough. NHS boards and the Scottish Government must improve the monitoring of boards’ use of waiting list codes if they are to retain public trust and assure patients they are being treated fairly.

“During the period we reviewed, the Scottish Government and boards were focused on making sure waiting times targets were being met but not giving enough attention to how this was being done.”

The Audit Scotland report also highlighted the difference between many NHS board figures for the actual number of patients waiting over nine weeks (around 24% for NHS Borders) and the percentage figures for reported waits of over nine weeks (around 4%).

Explaining the differences NHS Borders say: “The first figure showing the actual time waited includes all patients on our inpatient waiting list. This also includes those who were unavailable.

“Patients are often unavailable for treatment. They might be medically unfit for treatment, opting to defer treatment for personal reasons or choosing to wait for treatment locally.”

It was the use of certain codes by some health boards to identify patients being ‘unavailable’ that Audit Scotland regarded as “inappropriate” but NHS Borders was not under fire for this.

Audit Scotland said that the waiting list systems have inadequate controls and audit trails, and limited information is recorded in patient records, making it impossible to trace all the changes made to the records of patients waiting for treatment, or to identify the reasons.

From October 2012, NHS boards have had a legal requirement to treat inpatients within 12 weeks from the time the decision is made to go ahead with treatment, but South of Scotland Lib Dem MSP Jim Hume is concerned that this is ‘piling pressure’ on the NHS to the detriment of patients.

“The Scottish Government and NHS Boards were focused on meeting waiting time targets and not enough attention was given to how this was being achieved. With higher demand, fewer staff and financial challenges, the SNP are piling pressure on our NHS and patients are paying the price.”