Our performance

Providing an efficient service

Patient admissions

A total of 29,263 patients were admitted to the Trust in 2008/09. This compares with 26,421 in 2007/08. Of these, 23,825 were elective (planned) and 5,438 were emergency.

Outpatient clinics

The number of patients seen in outpatient clinics increased again this year, to 98,257 (see table below).

Number of patients seen in outpatient clinics

Cancelled operations

Cancelled operations are distressing for patients and so our objective is to keep them to a minimum.

This year our percentage of cancelled operations fell to 1.22 per cent (see table below). When operations are cancelled, patients must be readmitted within 28 days. There were no breaches of this standard in 2008/09.

Percentage of cancelled operations

 

Inpatients

The overall waiting time target for inpatients remained at 26 weeks from decision to treat to inpatient admission for 2008/09. We had one breach of this standard.

Revascularisation patients

The maximum wait target for patients requiring revascularisation procedures – cardiac bypass surgery or angioplasty, in which narrowed arteries are widened – was 13 weeks from decision to treat to inpatient admission for 2008/09. We had no breaches of this target.

Outpatients

The overall waiting time target for outpatients remained at 13 weeks from GP referral to first outpatient appointment this year. There were no breaches of this standard.

Cancer patients

The waiting time for patients referred by their GP with a suspicion of cancer is 14 days (two weeks). We had no breaches of this standard in 2008/09.

The waiting time for patients who have been diagnosed with cancer is 31 days (one month) between the decision to treat and the start of their first treatment. We had no breaches of this standard in 2008/09.

The waiting time target for patients urgently referred by their GP for suspected cancer is 62 days (two months) from referral to treatment. This includes time spent waiting or having diagnostic tests at other hospitals before being referred to us.

The way that this target is measured changed at the end of December 2008 so that patients who are too ill to have an operation are no longer taken off the waiting list on medical grounds.

For the period April to December 2008, we had three breaches to the 62 day target. In two of these cases, patients had been referred to us having already waited more than 62 days so were counted as breaches against another NHS Trust. The remaining case was counted as a shared breach with another NHS Trust.

For the first quarter of 2009, due to the new system of measurement, we had three breaches to the 62 day target. Of these, two were reallocated to another NHS Trust and one was counted as a shared breach with another NHS Trust.

Diagnostic waits

The 18 week wait

From December 2008, the 18 week wait became the definitive target against which NHS waiting times are measured. Existing waiting time targets specify how long a patient should wait during each stage of their treatment – from GP referral to outpatient appointment and from decision to treat to inpatient admission. With this new target, waiting is seen in a fundamentally different way and sets a maximum time of 18 weeks from the point of initial referral up to the start of any treatment necessary.

The 18 week target is expected to eventually replace the individual outpatient and inpatient targets reported above.

Measuring performance

Tolerances have been set to allow for patient choice, patients not attending appointments and clinical complexity. The operational standards of delivery for the NHS are:

• 90 per cent of pathways where patients are admitted for hospital treatment should be completed within 18 weeks

• 95 per cent of pathways that do not end in an admission should be completed within 18 weeks.

Meeting the standards early

Through a concerted team effort and collaborative work with our referring hospitals, we have made sustainable changes to clinical and administrative processes which support patients accessing diagnostics and treatment faster than before.

The 18 week standard for admitted patients was met and exceeded in September 2008, three months ahead of schedule. For non-admitted patients, the standard was met in December, the national deadline. We also met 18 week data completeness standards.