An independent report into waiting times management at NHS Lothian published in March last year revealed that its board members had been receiving wildly inaccurate information which had been manipulated to make it appear that thousands of patients had not waited beyond a 12-week target for treatment.
Red-faced Lothian health bosses have now been forced to admit that figures included in official monthly board papers since the summer, showing the number of patients who had been waiting more than six months since being added to lists, had also been wrong and had painted a far more positive picture than the reality.
It is understood that the mistake was only uncovered after a member of the waiting times team went on holiday, with a colleague realising the gaffe.
Chief executive Tim Davison has pledged action, saying “while any mistake is a concern, the fact that we found it, will learn from it and reported it is probably a strength”.
But Conservative MSP and health spokesman Jackson Carlaw reacted with astonishment to the error, which came about following a mistake in NHS Lothian’s waiting times office by a member of staff whose work was not checked.
He said: “If there was one health board in Scotland you’d think would now be getting this right it’s NHS Lothian. But it seems the reverse is true, and the time is right for the Scottish Government to step in.
“If health boards are not presenting correct figures on waiting times, the whole process of monitoring and reporting them is rendered utterly useless.”
The figures in the board papers were presented as “unadjusted waits”, indicating that they did not take account of periods in which patients had not been available for social or medical reasons.
But in reality the figures given to bosses and board members were adjusted due to the factors, meaning they had been given an incorrect account of the true picture on the ground.
It meant that in September, board members were told in the official papers that 638 patients had been on waiting lists for six months or more in August, when the true figure was 1331. Incorrect information was then published in four subsequent sets of papers.
Health board chairman Dr Charles Winstanley said: “It’s a concern if incorrect information is provided, but there has been no effect on patients.”
It is understood that the oversight was a result of human error and while there is no suggestion that board members were deliberately misled, the episode has raised fresh doubts over the way information is recorded.
Labour Lothians MSP Sarah Boyack said: “This all looks like an embarrassing mess. We should be able to trust the waiting times information issued by the board, especially after the last figures were completely discredited. It’s vital that the board acts urgently on the true level of waiting times people have had to suffer.”
Mr Davison, right, had asked for the figures to be included in board papers following a front page story in the News in July, which highlighted the time that victims of the waiting list debacle had faced for appointments.
Then, more than 200 people had been on waiting lists for 18 months or more, and while the numbers waiting excessive lengths of time had been falling – 78 people had been on lists for a year-and-a-half in February when adjustments for social or medical reasons were not taken into account. When adjustments are considered, 12 people had waited beyond 18 months in February, with 46 waiting beyond a year.
Mr Davison told the board: “I hope board members will recognise the fact that we are reflecting the problems on this issue as part of our approach to being transparent. It is a bit of analysis which I asked for, which I thought would be quite a good thing to report. This was an additional bit of data we constructed ourselves. They were the correct figures when adjustments were factored in – these were not fabricated numbers.”
Professor Alex McMahon, director of strategic planning, performance and reporting and information at NHS Lothian, said: “We are looking at all of our systems and processes to make sure there are checks and balances to mitigate against such errors in the future.”
TREATMENT STARTING FROM 62 DAYS OF REFERRAL
NHS Lothian’s waiting times crisis may have erupted more than a year ago with the publication of a damning report, but patients are continuing to suffer.
Although the health board’s £27 million plan to bring down the backlog has made significant inroads, 422 people who need inpatient procedures were waiting beyond a 12-week target in February, alongside 2869 outpatients.
Betty McAlpine, a grandmother from Musselburgh, said last July that she had waited 14 months for an operation to cure a bladder problem that had made her life a misery for five years.
Although she eventually had the operation in August, it proved unsuccessful and the 69-year-old said she recently received a letter saying an appointment at a clinic originally scheduled for today had been put back until November.
She said: “I don’t know what they’re playing at, it’s ridiculous. People are getting mucked about. There was no reason given for the delay, they just said it had been rearranged. I’m not impressed at all to find out that these people [board members] haven’t been told about what’s going on – they won’t have realised how long so many people were waiting.”
Cancer patient delays improve
NHS Lothian is turning a corner in its battle to offer prompt treatment to cancer patients.
The health board came in for heavy criticism after the Evening News revealed in January that nearly ten per cent of patients had faced delays beyond the Scottish Government target of 62 days for potentially lifesaving treatment to begin after an urgent referral – one of the worst rates in the country.
However, after health bosses brought in a raft of new measures, the figure has hit 97 per cent in the three months to the end of December, catapulting NHS Lothian above the national average, taking it beyond the expectation of 95 per cent of patients starting treatment within target.
The dramatic improvement arrested a worrying decline over the previous three quarters, making it the best performance reported in more than a year.
Professor Alex McMahon, strategic planning director at NHS Lothian, said: “Over the past year, we have successfully reduced the amount of time patients wait for cancer treatments. To achieve this, we have enhanced our patient treatment processes and have developed improvements in various departments, including urology, colorectal, breast, gynaecology and head and neck.
“We have appointed additional clinical staff, set up specialist clinics, invested in new equipment and reassessed patient care to ensure each patient receives the most efficient and effective treatment.
“Investment in key diagnostic services has also been made in conjunction with the Detect Cancer Early programme to meet the demand resulting from the Scottish Government campaigns.
“Although our cancer waiting times have markedly improved, we are still making every effort to make sure all patients are seen and treated as early as possible.”
The health board said the improvement had been sustained since the figures were reported, with a rate of 97.2 per cent in being reported in January.
Developments include an overhaul of lung cancer services, meaning patients are sent for chest X-rays before referral, speeding up treatment.
New microsurgery equipment has been brought in to the colorectal department, and new one-stop neck lump clinic has been established, resulting in a significant improvement in the 62-day performance in the area.
Some cancers, such as those in urology, saw NHS Lothian fail to meet the 95 per cent target, although performance rose from 82.5 per cent between July and September, to 90.3 per cent.
NHS Lothian also performed well against a target to begin treatment within 31 days after the course of action was agreed with a patient with cancer.
It achieved the goal in 98.6 per cent of cases, above a national average of 98.1 per cent. In January, the target was met 98.8 per cent of the time.
Independent Lothians MSP Margo MacDonald said: “Congratulations are due to the planners and staff throughout the hospitals. But I still feel NHS Lothian is being asked to juggle too much for too little in the way of cash for the growing numbers of patients in our area.”