Trusts fail to discipline those who manipulate waiting lists

Public confidence in the NHS has been undermined by the way that waiting lists have been deliberately manipulated, Edward Leigh MP, chairman of the Committee of Public Accounts, said this week at the publication of the committee's two latest reports.

The committee found that arrangements for identifying those responsible for manipulating lists and for taking disciplinary action fell well short of good practice.

The reports said that although there had been some improvement in waiting lists and waiting times, some uncertainty remained about the accuracy of the figures, partly because not all hospitals validated their waiting lists often enough.

In its 46th report, the committee looked particularly at the extent and causes of inappropriate adjustments made by some NHS trusts, how investigations into the adjustments were handled, the impact on patients, and the steps being taken to prevent a recurrence.

It found that in at least 10 hospitals, managers and staff made inappropriate adjustments to their waiting list data and statistics to hide the fact that they were missing government targets. In some cases the actions will have prolonged the suffering of patients and during this time their condition may have worsened.

The inquiries into the manipulation were not rigorous or complete and some of those allegedly responsible were allowed or encouraged to resign during the process. Some trusts breached NHS guidelines on agreeing confidentiality deals as part of severance packages, which cost the NHS some £260000 ($ 400000; €414000), and in some cases they did not include clawback arrangements when those involved went on to work elsewhere in the NHS. The Department of Health has promised to address this, the reports said.

Trusts had also taken steps to develop action plans covering the 6000 or so patients affected by the adjustments, including sending patients to other trusts and to the private sector for treatment.

However, the Department of Health still did not know the extent to which patients' health had suffered as a result of delays in treatment or whether compensation will have to be paid, the committee added.