The outcome, according to the region, is not the result of any one initiative or 'magic formula' but a determined drive over almost a decade to end long waits.
At the end of September, the region had just 175 patients on its waiting lists for more than a year, when the other 13 English regions combined had almost 69,000 patients waiting that long. The last 175 have now been cleared, the region says.
To ensure hospitals cut long waits, the regional authority has persistently held back money from its districts with which to top up government waiting-list money. It then hands the cash to hospitals for specific schemes intended to cut the longest waits and keep them down.
These have included installing at St Helens a 'mobile' operating theatre of the type used by the armed forces in the Falklands and the Gulf when lack of theatre time was causing long queues. Patients have been moved around the region to hospitals with the shortest waits; private hospital operations have been bought where that offered good value for money; and in some instances staff have operated in the evenings and at weekends to cut long waits.
The drive has included more doctors providing patients with firm dates for treatment rather than just putting them on waiting lists, while others have significantly cut routine re-attendance at out-patients' clinics, speeding up access to the waiting list. Both measures have helped reduce the numbers of patients who do not attend for treatment, while lists of patients willing to accept cancellations at short notice are kept. The elimination of long waits may have led to supply and demand for treatment reaching a balance, according to Sir Donald Wilson, the region's chairman. In March, according to Sir Donald, Mersey had just over 56,000 patients waiting for treatment. Just before Christmas the total waiting was 500 lower.
To ensure long waits come down and stay down, Ian Cumming, the region's performance manager, receives a monthly print-out detailing each consultant's waiting list in an attempt to spot lengthening queues before they become a problem, and to identify where short waits can be taken advantage of.
The data is made available to all GPs and to community health councils, and despite initial scepticism the community health councils are becoming convinced that the region really is eliminating long waits.
Geoff Ryall-Harvey, chief officer of Chester CHC, said: 'We receive virtually no complaints about waiting times for operations, unlike CHCs in London for example who tell me a great part of their caseload is advising people who are waiting a long time. When we do have a complaint, nine times out of ten there has been an administrative error that we can rapidly get sorted out'.
Doctors say the determination to ensure no one waits more than a year has led to some patients with less urgent conditions being treated ahead of more painful problems - but that the issue has become much less serious now that very long waits have been eliminated and the backlog of very minor cases no longer exists.Reuse content