Select Committee on Health Memoranda


Table 3.9.7(a)

INPATIENT WAITING LIST STATISTICS (ORDINARY ADMISSIONS AND DAY CASES AT 31 MARCH 2002 (NHS TRUST-BASED): TIME ON WAITING LIST

England by region

Waiting Time (months)
Total0-2 3-56-89-11 12-1415-17 18 months
RegionWaitingmonths monthsmonths monthsmonths monthsplus MeanMedian
Northern & Yorkshire123,415 64,05231,92117,845 9,2313660 03.92.9
Trent95,84954,496 24,48912,3834,295 18600 3.52.6
West Midlands87,72149,857 21,54110,7474,929 569780 3.62.6
North West164,31087,254 39,98121,99511,779 3,30100 3.92.8
Eastern116,39958,376 29,43516,5359,105 2,94710 4.13.0
London160,45880,931 39,03522,30013,222 4,97000 4.23.0
South East182,86585,592 48,22327,30715,396 6,34700 4.43.4
South West104,34851,107 27,39114,1458,021 3,4612230 4.23.1
England1,035,365531,665 262,016143,25775,978 22,1473020 4.02.9

Source: KH07 NHS Trust-based

Table 3.9.7(b)

INPATIENT WAITING LIST STATISTICS (ORDINARY ADMISSIONS AND DAY CASE ADMISSIONS) AT 31 MARCH 2002 (RESPONSIBLE POPULATION BASED): TIME ON WAITING LIST

England by region
Waiting Time (months)Total 0-23-5 6-89-1112-14 15-1718 months
RegionWaitingmonths monthsmonthsmonths monthsmonthsplus MeanMedian
Northern &

Yorkshire
122,351 63,55431,58617,715 9,1333630 03.92.9
Trent99,83956,525 25,52912,9624,592 23100 3.52.6
West Midlands84,56948,391 20,88210,2474,595 45400 3.52.6
North West159,87685,142 38,86921,27511,387 3,20300 3.92.8
Eastern123,89361,865 31,50917,6379,709 3,17210 4.13.0
London139,16869,914 33,80619,56811,477 4,40300 4.23.0
South East189,07288,542 49,80928,15016,029 6,53930 4.43.4
South West102,83650,656 26,93413,9097,837 3,2802200 4.23.1
England1,021,604524,589 258,924141,46374,759 21,6452240 4.02.9

Source: QF01 Health Authority based




3.9  Activity and Waiting Times

  3.9.8  Could the Department provide an update of Tables 4.16.4 to 4.16.8 on outpatient waiting times? [4.16b]

  1.  The first NHS Trust based outpatient data published were for the quarter ended 30 September 1994. They have since been published on a quarterly basis. The first published data on patients still waiting for more than 13 and 26 weeks were for the quarter ended 30 September 1996. A resident-based outpatient return has been collected from Health Authorities from April 1997 to March 1999, then collected on a Health Authorities responsible population from April 1999.

  2.  Table 3.9.8a shows the number of GP written referrals which, on 31 March 2002, had not yet been seen but had been waiting for 13 to under 26 weeks and 26 weeks and over.

  3.  Tables 3.9.8b to 3.9.8e show the number of patients seen for first outpatient appointment following GP written referral. This information is broken down by time waited (as a percentage) and by region and major specialty at Quarter 4 2002.

Table 3.9.8(a)

PATIENTS NOT YET SEEN FOLLOWING GP WRITTEN REFERRAL, TIME WAITING FROM REFERRAL TO QUARTER ENDED 31 MARCH 2002
England by regionGP written referrals not yet seen at end of quarter who have been waiting (weeks)
13 to under 26 26 and over
Region(thousands) (to nearest 10)
Northern & Yorkshire21 30
Trent160
West Midlands18280
North West2940
Eastern2340
London43430
South East290
South West15340
England1931,170

  Source: QM08. NHS Trust-based figures

Table 3.9.8(b)

PATIENTS SEEN FOLLOWING GP WRITTEN REFERRAL AND TIME WAITED FROM REFERRAL TO CONSULTATION, QUARTER ENDED 31 MARCH 2002
England by region


Number seen
following GP
written referral
Of those seen % who waited (in weeks)
Region(thousands) under 1313 to under 26 26 and over
Northern & Yorkshire273 78%18%5%
Trent21476% 18%6%
West Midlands22275% 20%5%
North West30475% 20%6%
Eastern21571% 20%8%
London33572% 21%7%
South East32673% 21%6%
South West22379% 15%5%
England2,11275% 19%6%

  Source: QM08. NHS Trust-based figures.

Table 3.9.8(c)

PATIENTS SEEN FOLLOWING GP WRITTEN REFERRAL AND TIME WAITED FROM REFERRAL TO CONSULTATION, QUARTER ENDED 31 MARCH 2002
England by specialty


Number seen
following GP
written referral
Of those seen % who waited (in weeks)
Specialty(thousands) under 1313 to under 26 26 and over
All specialties2,112 75%19%6%
Of which:
General surgery28184% 13%3%
Urology8974% 20%7%
Trauma and orthopaedics215 59%28%12%
Ear, Nose and Throat186 67%26%6%
Ophthalmology18769% 25%6%
Oral surgery7873% 20%7%
Plastic surgery3255% 23%22%
General medicine133 78%17%5%
Dermatology16369% 25%6%
Gynaecology19183% 15%2%

  Source: QM08. NHS Trust-based figures.

Table 3.9.8(d)


3.9  Activity and Waiting Times

  3.9.9  Can the Department provide information about current levels and past trends of patients' total waiting times from first referral to a specialist to eventual inpatient or day case treatment?

  1.  Information is not collected on patients total waiting times from first referral to a specialist to eventual inpatient or day case treatment.

3.9  Activity and Waiting Times

  3.9.10  Could the Department provide figures on how many people were removed from waiting lists for day case treatment and for in-patient treatment (i) because of admission for treatment and (ii) for reasons other than treatment? How many people were self-deferred in each six-month period since September 1988? What rules apply to ensure consistent interpretation of these figures? Has the Department made any assessment of the extent to which people removed for reasons other than treatment in that hospital had either been admitted, died, been treated in another hospital, or no longer required treatment? [4.16c]

  1.  Table 3.9.10a shows the total number of admissions and removals at six-monthly intervals from September 1998 to March 2002. Information on admissions and removals in 1997-98 is only available for the 12-month period between April 1997 and March 1998. The information collected centrally does not differentiate between the reasons for removal. It is therefore not possible to assess the extent to which patients have been removed for any particular reason.

  2.  Table 3.9.10b shows the number of patients who had self-deferred at six-monthly intervals from September 1988 to March 2002.

  3.  The NHS Data Manual has included the following definitions since November 1996:

    (i)  Removals other than admissions

    "A count of Elective Admission List Entries removed from the Elective Admission list during the period, for reasons other than admission. These are identified as entries that were removed on an Elective Admission List removal Date within the reporting period having an Elective Admission List Removal Reason of Patient admitted as an emergency for the same condition, Patient died or Patient removed for other reasons. It does not include suspended patients as they have not been removed from the Elective Admission List."

    (ii)  Deferred admission

    "A count of all Patients on an Elective Admission List at the census date who have had an Offer of Admission during the period who are self-deferred and who are still waiting for admission. The figures are split into those intended to be treated as ordinary admissions and those intended to be treated as day care admissions. Patient who have self-deferred a planned admission are excluded from this return."

Table 3.9.10(a)

NUMBERS OF ADMISSIONS AND REMOVALS
England by admission type
Ordinary Day Case
6 months to:Admitted RemovedAdmitted Removed
Sep 88941,36372,131 359,21318,419
Mar 89938,86486,256 392,64523,871
Sep 89959,51692,715 420,53626,784
Mar 90934,164109,963 454,26631,041
Sep 90910,557101,572 465,60336,409
Mar 91888,291125,408 496,55443,510
Sep 91918,376115,338 534,99847,616
Mar 92938,842157,759 601,31667,267
Sep 92901,687124,675 638,90567,044
Mar 93879,834139,707 691,20180,873
Sep 93829,580131,708 712,01685,040
Mar 94800,632137,604 768,24997,207
Sep 94796,780136,907 849,379111,295
Mar 95804,411143,757 925,446129,361
Sep 95763,117128,408 943,405131,830
Mar 96767,412139,901 1,026,419147,724
Sep 96761,967132,833 1,056,084154,879
Mar 97683,421117,203 1,047,602147,084
Sep 97** **
Mar 98** **
Sep 98687,330134,836 1,189,074194,417
Mar 99682,511136,383 1,267,592206,796
Sep 99662,461120,560 1,175,154175,132
Mar 00628,114130,814 1,216,451196,281
Sep 00632,607119,418 1,112,734172,900
Mar 01608,008133,715 1,113,989187,898
Sep 01598,444122,255 1,008,152164,812
Mar 02612,537128,485 1,025,052165,982

  Source: KH06 NHS Trust-based figures.

  *  In the year 1997-98, information was collected annually only.

Table 3.9.10(b)

NUMBER OF SELF DEFERRALS
England by admission type
Number at:
OrdinaryDay Case
Sep 8840,7538,433
Mar 8937,0988,769
Sep 8938,2249,905
Mar 9036,4419,735
Sep 9039,27411,865
Mar 9136,11511,998
Sep 9133,86812,469
Mar 9230,96513,151
Sep 9235,99218,134
Mar 9335,80019,095
Sep 9341,55024,142
Mar 9439,18925,185
Sep 9443,53834,946
Mar 9542,18837,152
Sep 9545,00442,650
Mar 9645,11244,908
Sep 9646,87649,632
Mar 9746,02249,390
Sep 97**
Mar 9856,63364,522
Sep 9842,33052,928
Mar 9940,09850,667
Sep 9938,95550,398
Mar 0036,27044,771
Sep 0037,01446,595
Mar 0135,61039,864
Sep 0138,82342,971
Mar 0234,61437,049

  Source: KH07A NHS Trust-based figures.

  * In the year 1997-98, information was collected annually only.

3.9  Activity and Waiting Times

  3.9.11  Could the Department provide charts and figures showing how trends in emergency and waiting list, booked and planned activity have moved with waiting lists sizes since June 1991? Could the Department provide both indices and actual numbers in each case? [4.16d]

  1.  Tables 3.9.11a and 3.9.11b and Figures 3.9.11 show growth in non-emergency (Waiting list, booked and planned) and emergency activity (FFCEs), and change in waiting list size, since the quarter ending 30 June 1992, the first quarter for which data are available. Table 3.9.11a provides indices and Table 3.9.11b provides actual numbers.

Table 3.9.11(a)

TRENDS IN NON-EMERGENCY AND EMERGENCY ACTIVITY AND WAITING LISTS
England—Indices
Quarter ended:
Non-Emergency Activity3Emergency Activity2 Waiting Lists
30 Jun 92100100 100
30 Sep 92104101 100
31 Dec 92104101 104
31 Mar 93100104 106
30 Jun 93104102 109
30 Sep 93107103 110
31 Dec 93103111 114
31 Mar 94119110 114
30 Jun 94111105 115
30 Sep 94116108 114
31 Dec 94120111 114
31 Mar 95122115 111
30 Jun 95118110 112
30 Sep 95122112 111
31 Dec 95127116 113
31 Mar 96128116 112
30 Jun 96123112 113
30 Sep 96127113 113
31 Dec 96127117 118
31 Mar 97123121 124
30 Jun 97123117 127
30 Sep 97125116 129
31 Dec 97127120 135
31 Mar 98127121 138
30 Jun 98133121 137
30 Sep 98137122 130
31 Dec 98142125 125
31 Mar 99139122 114
30 Jun 99137121 117
30 Sep 99138124 116
31 Dec 99139122 118
31 Mar 00143127 111
30 Jun 00138124 112
30 Sep 00141123 110
31 Dec 00145126 110
31 Mar 011145128 107
30 Jun 01139125 111
30 Sep 01141123 110
31 Dec 01144128 112
31 Mar 02149127 110

  Source: Health Authority quarterly monitoring and KH07 NHS Trust based figures  

  1.  Activity figures for this quarter are provisional.

  2.  From 30 June 1998, Activity Growth is calculated on an FFCE basis.

  3.  Non-emergency activity is General and Acute data (including waiting list, booked and planned cases) and does not include mental illness, learning disabilities or maternity services.

  4.  Figures for years prior to 2000-01 have been adjusted to allow for direct comparison.

Table 3.9.11(b)

TRENDS IN NON-EMERGENCY AND EMERGENCY ACTIVITY AND WAITING LISTS
England—Numbers
Quarter ended:Non-Emergency Activity3 Emergency Activity2Waiting Lists
30 Jun 92926,897791,130 937,054
30 Sep 92963,407801,086 939,740
31 Dec 92960,616801,647 977,189
31 Mar 93930,239822,792 994,974
30 Jun 93962,863803,533 1,019,341
30 Sep 93993,055817,612 1,032,038
31 Dec 93951,609877,831 1,065,782
31 Mar 941,099,452871,786 1,065,369
30 Jun 941,032,788833,989 1,077,497
30 Sep 941,073,195851,709 1,071,101
31 Dec 941,114,543875,000 1,070,492
31 Mar 951,134,119907,820 1,044,051
30 Jun 951,094,214869,324 1,052,958
30 Sep 951,134,007883,734 1,040,152
31 Dec 951,175,436916,607 1,054,948
31 Mar 961,190,999920,680 1,048,029
30 Jun 961,135,607883,631 1,056,122
30 Sep 961,177,810890,503 1,061,557
31 Dec 961,174,318926,795 1,104,983
31 Mar 971,138,904961,160 1,158,004
30 Jun 971,139,542926,938 1,189,962
30 Sep 971,161,315921,423 1,207,515
31 Dec 971,175,958949,407 1,261,915
31 Mar 981,177,967955,078 1,297,662
30 Jun 981,229,219955,699 1,287,543
30 Sep 981,267,153964,106 1,213,839
31 Dec 981,312,105986,828 1,173,598
31-Mar 991,284,262966,051 1,072,860
30 Jun 991,274,311960,345 1,094,251
30 Sep 991,276,723981,024 1,084,157
31 Dec 991,287,211968,724 1,108,006
31 Mar 001,322,1011,001,010 1,037,066
30 Jun 001,282,725983,023 1,047,890
30 Sep 001,307,259974,403 1,031,824
31 Dec 001,341,1931,000,474 1,034,381
31 Mar 011,345,3341,009,539 1,006,727
30 Jun 011,286,972990,187 1,037,875
30 Sep 011,304,738974,475 1,035,302
31 Dec 011,338,2391,015,931 1,050,221
31 Mar 021,383,4971,006,683 1,035,365

  Source: Health Authority quarterly monitoring and KH07 NHS Trust based figures.

  1.  Activity figures for this quarter are provisional.

  2.  From 30 June 1998, Activity Growth is calculated on an FFCE basis.

  3.  Non-emergency activity is General and Acute data (including waiting list, booked and planned cases) and does not include mental illness, learning disabilities or maternity services.

  4.  Figures for years prior to 2001-02 have been adjusted to allow for direct comparison.


3.9   Activity and Waiting Times

  3.9.12  Can the Department provide a comparison of total numbers of people waiting for outpatient appointments for each year for which figures are available, separately identifying trends in the average wait for an outpatient appointment? [4.16e]

  1.  Table 3.9.12 shows the average waiting times for first outpatient appointments at each quarter since the quarter ending 31 December 1994 and the number of attendances for the same period.

Table 3.9.12

AVERAGE WAITING TIMES AND NUMBERS FOR FIRST OUTPATIENT APPOINTMENTS
England
QuarterMedian waiting time (weeks) Outpatients seen after GP written referral Total first attendances seen
Q3 1993-946.011,490,439 1,683,116
Q4 1993-945.471,809,117 2,118,240
Q1 1994-955.421,603,723 1,966,464
Q2 1994-955.692,026,726 2,411,193
Q3 1993-955.822,019,438 2,412,634
Q4 1994-955.722,003,009 2,569,639
Q1 1995-966.011,804,040 2,415,895
Q2 1995-966.311,847,549 2,524,893
Q3 1995-966.071,904,040 2,566,011
Q4 1995-966.022,010,249 2,715,403
Q1 1996-976.131,869,773 2,577,037
Q2 1996-976.181,893,706 2,635,007
Q3 1996-976.051,921,446 2,650,803
Q4 1996-976.051,880,217 2,642,116
Q1 1997-986.171,904,564 2,689,803
Q2 1997-986.371,896,977 2,675,056
Q3 1997-986.251,888,560 2,663,871
Q4 1997-986.271,919,032 2,732,305
Q1 1998-996.491,827,140 2,660,499
Q2 1998-996.801,881,607 2,739,913
Q3 1998-996.891,894,358 2,732,047
Q4 1998-996.991,929,607 2,803,960
Q1 1999-007.091,837,726 2,714,179
Q2 1999-007.311,907,904 2,798,366
Q3 1999-007.321,935,766 2,791,712
Q4 1999v007.582,028,664 2,953,779
Q1 2000-017.111,884,939 2,795,853
Q2 2000-017.451,949,273 2,863,533
Q3 2000-017.382,005,711 2,919,968
Q4 2000-017.382,098,170 3,050,816
Q1 2001-026.891,895,469 3,020,570
Q2 2001-027.211,961,853 3,099,821
Q3 2001-027.272,047,053 3,209,768
Q4 2001-027.572,111,633 3,282,456

  Source: QM08 NHS Trust-based figures, KH09Q (attendances 2001-02).

3.9  Activity and Waiting Times

  3.9.13  Can the Department estimate the number of people at each access point of the elective care system broken down to show:

    (a)  numbers of GP consultations

    (b)  numbers of referrals to specialist outpatient clinics

    (c)  numbers of attendances at specialist outpatient clinics

    (d)  numbers of placements on waiting lists (differentiated by (i) "waiting list", (ii) "booked" and (iii) "planned", and

    (e)  numbers of elective episodes of care, for each year since 1991-92 [4.16f]

  1.  Table 3.9.13a shows an estimated total number of consultations with GPs in England each year—including surgery, telephone and home visit consultations.

  2.  The estimates are arrived at by using two published ONS sources—The Results of the General Household Survey and ONS mid year population estimates.

  3.  This year a more refined method of estimation has been used to improve the accuracy of the estimates and this has resulted in a general lowering of the estimated total number of consultations. However, it has not affected the year on year trends.

  4.  The method adopted this year employs age and sex stratified consultation rates with estimated numbers of people within each age band and is the method which has been agreed after consultation with OME and the BMA who use related data supplied by us in the DDRB.

  5.  Because of this all the figures within the table are different to those provided in previous years but now correspond with publicly available information.

  6.  Even though consultation numbers seem to have dipped from the mid nineties this does not necessarily reflect a dip in the workload of GPs as numbers only represent one dimension of the workload and cannot measure the complexity and length of consultations.

  7.  Table 3.9.13b shows the number of referrals for first outpatient appointments for each quarter since the quarter ending 31 December 1994.

  8.  Table 3.9.13c shows the number of attendance's at first outpatient appointments for each quarter since the quarter ending 31 December 1994.

  9.  Table 3.9.13d shows the number of placements on waiting lists on a quarterly basis since the quarter ending June 1991. Data on numbers of placements on waiting lists differentiated by waiting list, booked and planned are not collected centrally.

  10.  The first column of Table 3.9.11b shows the number of elective episodes of care (waiting list, booked and planned) on a quarterly basis for each year between 1992-93 and 2001-02. The quarter ending 30 June 1992 is the first quarter for which data are available.

Table 3.9.13(a)

ESTIMATED TOTAL NUMBER OF NHS GP CONSULTATIONS IN ENGLAND PER YEAR
YearTotal consultations
(to the nearest 1,000)
1990243,417,000
1991215,498,000
1992233,598,000
1993253,647,000
1994225,662,000
1995237,265,000
1996256,423,000
1997na
1998219,512,000
1999na
2000223,690,000

  Source: The consultation estimates are prepared using General Household Survey (GHS) data and ONS mid year population estimates.


 
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