Barts Health NHS Trust has resumed publishing waiting times for routine treatment after fixing long-standing problems with the quality of data in its patient administration information.
The Trust stopped reporting non-urgent waiting time data in September 2014 and implemented a recovery programme that involved checking hundreds of thousands of data entries and completely rebuilding its waiting list.
The first robust data, published today, shows that in April 2018 88,333 patients were waiting for routine treatment. Of these, 13,988 had been waiting longer than the national standard of 18 weeks. This means that over eight out of 10 patients who had been referred to a consultant but not yet started treatment were waiting within the national standard of 18 weeks.
Performance for the month was 84.2% against the national standard of 92%. While waiting for treatment to start, these patients may be having tests, scans, drugs and/or therapy in the meantime. The average time people had been waiting was under eight weeks.
Some patients are waiting too long for treatment to commence. In April, 36 people were waiting over 52 weeks and the Trust plans to clear this by the end of this financial year.
Since we suspended reporting, doctors undertook a comprehensive clinical harm review for every patient waiting over a year, and although some were inconvenienced, none have experienced significant harm.
Chief Executive Alwen Williams said: “I am very sorry that too many patients are waiting too long for their treatment. We are determined to improve waiting times for our patients and our new improved waiting list systems will help us to do just that.
“I would like to pay tribute to the teams who have identified and fixed significant technical issues within our systems, and I am grateful for the support we have had from other organisations. It was clearly unacceptable that we weren’t able to report data for so long, but it was crucial that we got to the root of the problem and we are now confident that these significant issues have been fixed once and for all.”
How the issues were resolved
In August 2014 the Board of Barts Health Board decided Trust performance data was not reliable and suspended reporting while the problem was diagnosed and fixed. We commissioned an independent investigation and implemented a recovery plan. Experts meticulously combed through the groups of data which together compromised the waiting list, and uncovered pockets of data that had never been properly processed owing to inconsistent practices.
This can happen if, for example, a patient waiting for a routine operation is admitted and treated as an emergency, but subsequently never taken off the waiting list; or an appointment is cancelled but the patient is not officially discharged; or a patient is transferred to another provider and the pathway is not closed on the Barts Health system.
A huge number of pathways checked turned out to be patients who had been either treated, discharged or no longer required care.
While the experts were checking these pathways, they were still visible in the front-end system that doctors, nurses and receptionists use to book appointments for patients. The day-to-day process of managing a patient’s journey was unaffected, and hundreds of thousands of patients continued to have treatment with a Barts Health consultant during the recovery period.
We left no stone unturned in the search for an effective and robust way for reporting patient waiting list data, and constructed a bra nd new overall waiting list. This gave the Board confidence that Trust data is now reliable and robust.