Patients cannot wait for NHS to cope with demand

THE measuring and regular reporting of waiting times is meant to enable monitoring of NHS Scotland’s performance, allowing delays in the system to be identified and addressed.

A fall in the proportion of patients receiving key diagnostic tests on time is itself an early warning of problems.

The problem is it is a warning sign which has been seen before and gone unheeded. Since early last year the proportion of patients receiving vital tests such as CT scans and internal examinations such as an endoscopy on time has been going steadily downward.

In June 2016, 92.2 per cent of patients were waiting less than six weeks, but that fell to 86.7 per cent by March this year and as of June 2017 had dropped further to 82.9 per cent.

These are significant decreases in a target which is particularly crucial given the importance of these tests for intervening early in serious illnesses such as cancer.

The reasons for the decline are unclear – although one is familiar. Scotland’s population is ageing and that puts increased demand on a wide range of health and social services. There are simply more people who need such tests; 79,529 patients were waiting for one of eight key diagnostic tests as of June this year, compared with just over 61,000 a year ago, according to NHS figures.

A shortage of consultant is also contributing to difficulty meeting six-week waiting time targets and there are also not enough of the radiologists whose expertise is interpreting scans once they have been carried out.

In the Scottish Government’s defence, it has invested in more medics, but seen consultant vacancies continue to rise beyond 400, due to a need to continue to recruit to meet rising demand.

Ministers also announced £50 million of funding earlier this year to help cut waiting times. This included spending on new tests for bowel cancer which will cut the need for colonoscopies significantly. But this will take time to roll out.

Even despite such initiatives, these figures remain concerning, particularly if you are in an area where waiting delays are higher than average, since there are wide variations between health boards.

The figures matter because, as we all know, the early detection of illness can make a critical difference to a patient’s chances of survival, particularly in the case of cancers.

Cancer Research UK suggests health boards with lower waits could share skills and capacity with neighbouring areas where waits are longer and this idea should be considered, by the new expert group appointed by Health Secretary Shona Robison to help boards tackle waiting times for elective procedures and diagnostic tests.

That should only be the start of a major effort to reverse this trend. These statistics are not a blip but a warning sign that NHS Scotland cannot carry on with business as usual. Demand is only set to rise and long waits for diagnostic tests have real consequences for patients – in some cases very serious consequences indeed.