Fewer patients suffering long NHS delays

NICHOLAS TIMMINS

and COLIN BROWN

The number of NHS patients waiting more than a year for hospital admission has dropped to an all-time low, Stephen Dorrell, the Secretary of State for Health, said yesterday.

The number waiting over 12 months fell by a quarter between September and December, to 20,892 despite a 10,000 rise of 1.3 per cent in the total number waiting to 1,054,560.

Just 2 per cent of patients are now waiting more than a year for admission once it is decided they need it, Mr Dorrell told a seminar at Bolton, Greater Manchester. Five years ago, 20 per cent, or nearly 200,000 people waited that long.

The figures, which reveal a marked success story for waiting list-type admissions, can be squared with recent reports of dramatic pressure on emergency admissions and may even be part of their cause, according to Anthony Harrison, a fellow at the King's Fund Institute, a health services think-tank.

"Some of the improvement is because of the switch to day case surgery which is increasingly carried out in dedicated day surgery units," he said. Unlike conventional surgical wards, these tend to be protected from being taken over by emergency admissions in the winter. As a result, waiting times for elective surgery fall, while the pressure on the remaining medical and surgical beds rises, producing waits on trolleys and transfers between hospitals.

"There has been a genuine improvement in waiting times for elective [waiting- list type] admissions, but the price has been to take greater risks with emergency admissions," Mr Harrison argued. "There is always a balance between the two. It may be that the balance has gone too far the other way."

The latest provisional figures show falls in six of the eight NHS regions for those waiting over a year, but two regions - Trent and the South & West - have shown small rises. The pressure since Christmas means that "certainly in some hospitals they have been saying that the targets for elective treatments will have to give", Mr Harrison added.

Gerald Malone, the Health Minister, is to launch a charm offensive today aimed at persuading GPs to provide more minor accident and emergency cover, thereby relieving pressure on hospital departments.

The move is part of consultations on expanding the role of GPs which could lead to a new family doctors' contract. In a series of meetings starting in south London he will consult on what types of work could be transferred, including shifts that would see nurses undertake more of the routine procedures.