An Audit Commission report published this week has found that most NHS trusts have serious flaws in how they collect and report data on waiting lists.
Errors in reporting waiting lists were found in 19 of the 41 trusts investigated; system errors that could increase risk of reporting errors were found in 15 trusts; and three trusts deliberately misreported information on their waiting lists. Only three of 41 trusts were given the all clear.
The report, part of a five year rolling programme of spot checks of trusts, was commissioned by the Department of Health in an attempt to reassure the public that published statistics on waiting lists are robust.
Peter Wilkinson, director of health at the Audit Commission, said: “We think that it is very important that the Department of Health thoroughly investigate this.” He noted, however, that in the trusts accused of deliberately misreporting, prompt action had already been taken to deal with the issues identified. This has included the suspension of certain staff.
An independent inquiry into the deliberate misreporting at South Manchester University Hospitals NHS Trust in the period up to 2002, which was made public as the BMJ went to press, has implicated a number of former trust senior executives.
The inquiry, which began in October 2002, concluded that the process of adjusting the figures probably began before May 1997 and manipulation was done in an attempt to boost the trust's performance report, thus showing a more favourable position against the Government's targets than was truly the case.
Dr Neil Goodwin, chief executive of the Greater Manchester Strategic Health Authority, said in a statement, “It is totally unacceptable for anyone in the NHS to mislead the public about their performance,” and announced that South Manchester University Hospital NHS Trust would lose its one-star rating as a result.
Accurate waiting list data are essential for ensuring the appropriate targeting of resources in trusts and to provide evidence of efficiency in public spending. Waiting list targets are particularly important to trusts because decisions on awarding more freedom and flexibility to the best performing trusts or on intervening in poor performing trusts is often based on this information.
The report highlights many reasons for the problems, including the complexity in the organisation of waiting lists, the large number of staff needed to maintain them, and information technology problems as a result of recent trust mergers. It called for commitment from trusts to improve staff training and data systems. 
Footnotes
Waiting List Accuracy: Assessing the accuracy of waiting list information in NHS hospitals in England is available at www.audit-commission.gov.uk