Hospital waiting lists and pressures on the NHS
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《英国医生杂志》
The English NHS has set hospitals targets to reduce the numbers of patients with long waits. However, for the average NHS patient, it is the average waiting time that is of concern, particularly for specialties with high mortalities. We examined hospital NHS inpatient waiting lists and waiting times published by the Department of Health for the financial years 1998-9 to 2004-5. We also used hospital episode statistics from 1996-7 to 2004-5 to study average waiting times for people admitted to an NHS hospital for an operation.
The bottom line
From 1999 to 2005 the number of patients waiting six months or more on Department of Health's waiting lists fell by 85%; the number waiting less than six months fell by 2%
For specialties with high inpatient death rates, the number waiting less than six months increased by 8%
For specialties with low inpatient death rates, the number waiting less than six months fell by 11%
The average time waited by patients was the same in 1997 and 2004 (87 days) but increased between those years
We analysed waiting lists for NHS English hospital trusts published by the Department of Health for the period from 1 April 1998 to 31 March 2005 (www.performance.doh.gov.uk/waitingtimes/). We divided the specialties into those with more than 1% inpatient mortality (28 specialties) and those with less than 1% (36 specialties) in the year to 31 March 2004. The high mortality group had an average death rate of 3.3%, and accounted for 97% of hospital deaths and 73% of hospital episodes. The low mortality group had an average death rate 0.2%. Overall, since 1999 the numbers waiting for admission over six months have reduced (mainly from 2002), but—for patients in specialties with high hospital mortalities—waiting lists for people waiting under six months increased by 8% (fig 1).
We also analysed hospital episode statistics for England from 1 April 1996 to 31 December 2004 to determine the average waiting time from the date of decision to admit to actual admission. The average waiting times were about the same at the end of this period as at the beginning but increased by as much as 28% in the intervening years (fig 2). A similar picture emerged for individual procedures. The total available NHS hospital beds in England decreased from 198 958 in 1996-7 to 184 207 in 2003-4—a reduction of 7.4%, and bed occupancy increased.
The basic figures
From 1999 to 2005, Department of Health figures show the numbers on the waiting list for NHS hospital admission for less than six months fell from 793 233 to 780 306. The numbers waiting six or more months fell from 279 627 to 41 380.
Over this period, those waiting less than six months for the 28 specialties with inpatient death rates over 1% rose from 383 513 to 415 318 (8% increase); for the 36 specialties with death rates under 1% the numbers fell from 409 720 to 364 988 (11% reduction).
For cardiology, the number of patients waiting less than six months increased by 84%; for ophthalmology it decreased by 36%.
Average waiting time, from hospital episode statistics, of those entering hospital for all admissions was highest (102.8 days) in the third quarter of 1998.
This month's Dr Foster's case notes were compiled by Brian Jarman at the Dr Foster Unit at Imperial College and Steve Middleton from Dr Foster Ltd. Dr Foster is an independent research and publishing organisation created to examine measures of clinical performance.(Brian Jarman, Steve Middleton)
The bottom line
From 1999 to 2005 the number of patients waiting six months or more on Department of Health's waiting lists fell by 85%; the number waiting less than six months fell by 2%
For specialties with high inpatient death rates, the number waiting less than six months increased by 8%
For specialties with low inpatient death rates, the number waiting less than six months fell by 11%
The average time waited by patients was the same in 1997 and 2004 (87 days) but increased between those years
We analysed waiting lists for NHS English hospital trusts published by the Department of Health for the period from 1 April 1998 to 31 March 2005 (www.performance.doh.gov.uk/waitingtimes/). We divided the specialties into those with more than 1% inpatient mortality (28 specialties) and those with less than 1% (36 specialties) in the year to 31 March 2004. The high mortality group had an average death rate of 3.3%, and accounted for 97% of hospital deaths and 73% of hospital episodes. The low mortality group had an average death rate 0.2%. Overall, since 1999 the numbers waiting for admission over six months have reduced (mainly from 2002), but—for patients in specialties with high hospital mortalities—waiting lists for people waiting under six months increased by 8% (fig 1).
We also analysed hospital episode statistics for England from 1 April 1996 to 31 December 2004 to determine the average waiting time from the date of decision to admit to actual admission. The average waiting times were about the same at the end of this period as at the beginning but increased by as much as 28% in the intervening years (fig 2). A similar picture emerged for individual procedures. The total available NHS hospital beds in England decreased from 198 958 in 1996-7 to 184 207 in 2003-4—a reduction of 7.4%, and bed occupancy increased.
The basic figures
From 1999 to 2005, Department of Health figures show the numbers on the waiting list for NHS hospital admission for less than six months fell from 793 233 to 780 306. The numbers waiting six or more months fell from 279 627 to 41 380.
Over this period, those waiting less than six months for the 28 specialties with inpatient death rates over 1% rose from 383 513 to 415 318 (8% increase); for the 36 specialties with death rates under 1% the numbers fell from 409 720 to 364 988 (11% reduction).
For cardiology, the number of patients waiting less than six months increased by 84%; for ophthalmology it decreased by 36%.
Average waiting time, from hospital episode statistics, of those entering hospital for all admissions was highest (102.8 days) in the third quarter of 1998.
This month's Dr Foster's case notes were compiled by Brian Jarman at the Dr Foster Unit at Imperial College and Steve Middleton from Dr Foster Ltd. Dr Foster is an independent research and publishing organisation created to examine measures of clinical performance.(Brian Jarman, Steve Middleton)