NHS "legal" wait rights a mistake, warns Sir Harry Burns

Waiting time targets can put pressure on clinicians to rush patients through he system
Waiting time targets can put pressure on clinicians to rush patients through he system
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Scotland's former chief medical officer has said a flagship NHS guarantee which enshrines patient waiting times in law was a mistake.

Sir Harry Burns also called for a rethink on the 18 week referral to treatment (RTT) guarantee for patients with cancer as it could mean patients don't get the best treatment.

He was speaking as he published a report today into the use of targets and indicators and in Scotland. It calls for broader approach to healthcare and understanding what makes people unwell in the first place, rather than just focusing on narrow targets.

The Scottish Government introduced the legally binding right to receive operations within 12 weeks of being added to the waiting list as part of the Patient Rights Act in 2011. But it has been breached thousands of times over years, as hospitals fail to meet targets.

It was put to the former chief medical offficer that he seem "critical" of this being put into law.

He replied: "Well, yes, because clinical practice isn't like that.

"There are always circuimstances, if someone is coming up to 11 week and five days and they're due to come in on the sixth day and they've got a cold or something like that. You breach the target. And OK, you can have ways of taking them off, but it's just not the way clinical practice works."

Scotland is the only country in the world which currently an 18 week referral to treatment (RTT) guarantee for cancer care, alongside the 12 week legal maximum wait for treatment after being referred. The report says the former should be dropped as it may "alter clinical decision making" as doctors are too keen to see the patients meet targets instead of being clear about the right course of treatment.

Sir Harry added today that "complex investigations" may be needed, while patients may need to time to think about their treatment. He backed the retention of the 12-week limit despite reservations about its legal standing.

He also conceded that targets have had a positive impact in speeding up NHS treatment in recent decades and should be retained, particularly in areas like A&E.

Dr Peter Bennie, Chair of BMA Scotland, said: "We have consistently stated that we do not believe that any political guarantee regarding specific waiting times has a place in law. During the progress of the Patient Rights Bill, the BMA lobbied for this legally binding guarantee to be removed, because in our view, the widespread use of centrally imposed treatment time targets can have unintended consequences, distort clinical priorities and could lead to poorer outcomes for patients."