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PCTs delaying operations to 'save money', says CCP


Health bosses are deliberately making patients wait for treatment so they will remove themselves from waiting lists by either going private or dying, a report has suggested.

Some Primary Care Trusts (PCTs) are refusing to operate before 15 weeks in a bid to save money, an independent agency that advises the Department of Health has discovered.

The tactic was employed by PCTs after they found that if patients were made to wait longer “some will remove themselves from the list or will no longer require treatment when it is finally offered.

“A PCT may therefore save money overall by increasing waiting times,” the report said.

“We understand that patients will ‘remove themselves from the waiting list’ either by dying or by paying for their own treatment at private sector providers,” the report by the Co-operation and Competition Panel (CCP) said.

The terms of the NHS Constitution states that patients should be seen within 18 weeks, but the panel has been told by some PCTs that they are imposing minimum waiting times of up to 15 weeks. The DoH guidance is to treat patients within 18 weeks but there is no specific guidance on a minimum waiting time.

Some PCTs said that increasing waiting times had the potential to save money, but the authors of the report pointed out that when treatment is delayed, more complex and expensive care can be required so money may not be saved in the long run.

The report said: “At an individual level, making patients wait longer than necessary for treatment is likely to impose greater pain and inconvenience than is necessary on patients.”

However, not all trusts impose minimum waiting times and provide care “as soon as a provider can safely deliver”.

The Patients Association said that the “cynical manipulation” of waiting lists should not be tolerated.

Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that some PCTs are imposing minimum waiting times of up to 15 weeks.

“We urge the Department of Health to take a firm stand on this issue, clearly demonstrating to PCTs that this deplorable practice has no place in the NHS.”

CCP chairman, Lord Carter of Coles, said: “Commissioners have a difficult job in the current financial climate, but patients’ rights are often being restricted without a valid and visible reason. Crucially, it is the lack of transparency that surrounds certain restrictions on patient choice that is of real concern.”

Health secretary Andrew Lansley said: “This is exactly why we need to put patients’ interests first. Too many PCTs have been operating in a cynical environment where they can game the system - and in which political targets, particularly the maximum 18 week waiting time target, are used to actually delay treatment.

“When GPs, specialist doctors and nurses are making the decisions, as they will under our plans, they will plan care on the basis of the clinical needs of patients and their right to access the best service, including the least possible waiting time.”



Readers' comments (7)

  • How does this work re RTT18? Are the PCTs not referring the patients on, or are they stipulating that after seeing a consultant the appointment for treatment must be delayed until after the patient has been waiting for 15 weeks. No wonder there are problems for acute Trusts when trying to comply with RTT18 if they only have a 3 week window in which to treat! With Annual Leave, sickness, Study Leave, etc, it must be a nightmare.
    And what about the patient who gets referred with, eg, serious carpal tunnel syndrome. The consultant may want to operate ASAP to reduce further damage to the nerve. Will the PCT delay things despite the consultants recommendation?

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  • no consideration is being given to the psychological trauma to patients being given this substandard and sometimes inhumane treatment by the NHS.

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  • I presume that this does not apply to the health bosses themselves when they require treatment? although I know that doctors, nurses and other hospital staff get the same treatment as everybody else even thought there are shortages through sick leave.

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  • What's not being said though is the reason this is happening is because of the squeeze on budgets. Lansley is being disingenuous to say the least!! The cynical environment he refers to is the very one he has created.

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  • A very good round up of the issue of markets and damage it causes. Easy read btw.

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  • "“We understand that patients will ‘remove themselves from the waiting list’ either by dying or by paying for their own treatment at private sector providers,” the report by the Co-operation and Competition Panel (CCP) said."

    this is totally appalling and not at all the philosophy or the concept of the nhs.
    on the other hand, however, perhaps this would be more convenient way of saving money if patients just went private or died a result of lack of care. the nhs could then be closed down altogether to save money so that there would be more to spend on immigrations, foreign aid and continuing the crusades which were started in the 11th century and which have still not been brought to a satisfactory conclusion!

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  • Anonymous | 31-Jul-2011 11:28 am

    further to my comment above. I cannot believe that anybody involved in health care actually said this. if they were on the nmc register they would have been suspended!

    If I was on a waiting list and so conveniently removed 'myself' by dying I wouldn't bother to inform them to cancel my appointment!!!!!!!!!!!!

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