Patients at some hospitals in England are still enduring “unacceptable waits” for routine diagnostic services, such as scans and blood tests, says the health watchdog body the Healthcare Commission. Although some substantial improvements have been made, performance varies widely, it says.
Its review of radiology, pathology, and endoscopy services shows that just 16 of the 153 trusts surveyed achieved the highest rating of “excellent”—meaning that patients were kept waiting no longer than 13 weeks for diagnostic services—while 15 were awarded the lowest score of “weak.” The remainder were rated as “good” or “fair” in equal measure.
The survey was carried out in September 2005 and will feed into final performance ratings that are due to be published in October. The trusts were assessed for the first half of 2005-6 on 14 indicators covering quality, efficiency and management, and patients' experience.
The findings have prompted the commission to question whether the government target of a maximum wait by December 2008 of 18 weeks from referral by GP to treatment will be uniformly met.
All trusts will need to comply with the 13 week time frame for diagnosis by March next year if they are to meet the 18 week referral to treatment target, says the commission. In 67 trusts patients waited more than 26 weeks for imaging services, the review showed.
From the end of April 2007 government rules mean that patients waiting longer than 13 weeks for imaging scans, such as ultrasonography, will be allowed to choose an alternative healthcare provider for the service.
The assessment highlights major reductions in waiting times for computed tomography and magnetic resonance imaging, despite substantial increases in demand, and falls in very long waits for endoscopies.
But across the country waiting times for routine endoscopies ranged from two weeks to more than a year. And the commission warns that the current pace of improvement is too slow to cope with the expected surge in demand when the rollout of the national bowel cancer screening programme is completed in 2009.
The review also found variation in the reporting of imaging results and in the turnaround times of many pathology tests, as well as widespread failure to record the success rates for colonoscopies.
Describing the review “as a very fair assessment,” Gill Morgan, chief executive of the NHS Confederation, which represents most NHS organisations, said: “There have been overall improvements, but it is clear that problems remain.”
Gill Markham, vice president of the Royal College of Pathologists, agreed but added that new protocols and surgical targets had put heavy pressure on imaging services.
She said she was “hugely concerned” about the ability of trusts to meet the 18 week target, amid so many other priorities, especially when so many trusts were in financial difficulty.
But responding to the review the health minister Caroline Flint said: “We are confident the NHS will deliver the new target.”
The full results of the review of diagnostic services are available at www.healthcarecommission.org.uk.