"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Wednesday, 6 October 2010

The Power of Targets

Today the Department of Health showed that there is an increase in the number of people that have to wait more than 6 weeks for a diagnostic test. There are two statistics, one is eye popping, the other is bland. It is the bland one that is the more important. First the eye popping one:
The number of patients, for whom English commissioners are responsible, waiting over 6 weeks for any one of the 15 key diagnostics tests at the end of August 2010 was 5,900, an increase of 2,100 (56.7%) from July 2010, and 1,900 (46.7%) from August 2009.
Wow 57% increase in the number of people waiting more than 6 weeks compared to July, or 47% increase on the same month last year. That is a huge rise! The problem is that the numbers are small compared to the total number of people actually having diagnostic tests (I estimate that the total is about 1.5 million). Yes, the rise is eye popping and it can be pinned on Lansley's diktat that targets have been abolished, but is this significant? Not yet, let's see how these figures go over the next few months.

The other statistic is more important because it gives the overall figures for waiting times:
Of the patients waiting at the end of August 2010, 98.9% had been waiting under 6 weeks, down 0.4% from July 2010 and 0.2% from August 2009.
The important point here is that we want no one to have to wait more than 6 weeks, so we want to make sure that 100% of people wait 6 weeks or less. 98.9% is good, but clearly 99.3% is better (the July figure). This shows that more people are waiting for their tests than in July this year or in August last year.

Now have a look at this graphic from @Davewwest from HSJ:

The waiting times under the Tories is the blue part at the right hand side. This does show a dip, but there really isn't enough information to say whether this is a trend or just a blip. Notice that there is a blip at January 2010, no doubt a Tory looking at the figures in January would say that fewer people were waiting less than 6 weeks and therefore things were getting worse under Labour. Clearly this is not the case because the figures went up again the following month: January was a blip.

However, the most important thing about this graph is that in January 2006 only 45% of people had their tests done within 6 weeks, but there was a relentless increase until March 2008 when it was around 98%. Of course the last few are always the most hardest to improve and yet we have still seen a trend upwards (albeit slower) until November 2009.

This graph amply shows the huge power of targets. If anyone says that targets do not work, show them this graph. My prediction is that now that Lansley has abolished targets the trend will be down, in fact I think that it will be down to 90% within a year. That will be the time that we can tell the Tories that targets really do work.

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