NHS waiting time increases may cost lives, doctors warn

Delays could mean illnesses reach stage where surgery or drugs cannot treat them, chair of BMA's consultants committee says

Patients could die because of rising NHS waiting lists for tests and treatment, the leader of Britain's hospital doctors has warned. Delays in identifying conditions such as cancer may mean that a patient's illness reaches the stage where surgery or drugs cannot save them, Dr Mark Porter told the Guardian.

Porter, chairman of the British Medical Association's consultants committee, said the growing delays were "inhumane" because the ensuing uncertainty added to patients' fear and suffering.

His remarks will add to the pressure on David Cameron, who has offered several recent personal guarantees that patients will not have to endure long waits to be treated.

A Guardian analysis of official NHS data on England's six main waiting time targets shows that five are increasingly being breached. The number of patients waiting more than six weeks for a diagnostic test such as an MRI scan has quadrupled in the last year, an extra 2,400 people a month are not being treated within 18 weeks, and 200,000 patients waited longer than four hours in A&E this year compared with the same period in 2010, the data reveals.

The growing number not being tested or treated within the required time limits was of particular concern, Porter said. "If patients are now exceeding those times, then those patients' treatment options are being limited, and if that happens then there's a potential for patients suffering harm.

"It may be that someone's disease progresses beyond the point where surgery might usually give a cancer patient a potential cure, but the patient then receives palliative care only," he said.

Previous success in ensuring patients did not experience long waits was at risk from the government's changes to the service and its £20bn efficiency drive, Porter said. "There's definitely a potential for patient harm from these growing waiting time problems. Patients will be waiting with anxiety and pain longer than they should be. That's inhumane."

Other medical leaders also expressed alarm. Professor Tim Evans, a vice-president of the Royal College of Physicians, said he was concerned about the small but growing number of cancer patients having to wait more than one or two months for treatment. "If you've just had a diagnosis of cancer, you want treatment as soon as possible, obviously. Therefore the fact that more patients are waiting longer, even small numbers, is a matter of great concern to clinicians. If you need treatment for cancer, the earlier you get it the better," said Evans. "Patients having to wait more than 31 or 62 days for their first treatment would feel anxious and concerned and require reassurance that this isn't going to affect their prognosis."

Doctors are also concerned that the number of patients waiting more than six weeks for a diagnostic test has risen from 3,378 to 15,667 in the last year. While only 2.7% of patients wait this long, the figure is 8.6% for those awaiting a colonoscopy and 8% for flexible sigmoidoscopy, another test for cancer.

"Waiting times for diagnostic imaging tests are showing a worrying trend upward," said the Royal College of Radiologists. "Radiologists and radiographers are trying their best to address the rise in waiting times for diagnostic imaging by working extended hours and weekends, but it is difficult to keep pace with increasing demand."

Professor Jon Rhodes, president of the British Society of Gastroenterology, said the rise in waits for procedures such as colonoscopy was "alarming". He added: "No one should have to wait more than four weeks for a diagnostic colonoscopy, since delayed diagnosis is a major factor underlying the country's relatively poor survival rates for colorectal cancer." The NHS had too few endoscopists to cope with demand, he added.

NHS data shows that while in May 2010, 337 patients had waited beyond six weeks for a colonoscopy, that had risen to 2,313 in May this year. Similarly, the number waiting past six weeks for flexible sigmoidoscopy has jumped from 87 to 1,199, and those waiting for echocardiography from 574 to 2,034 over the same period.

Dr Peter Carter, general secretary of the Royal College of Nursing, warned that the government's health policies were worsening the situation. Abolishing primary care trusts, the NHS bodies charged with ensuring patients are treated within time limits, had weakened patients' rights, he said. Making more patients wait longer would prove to be "a false economy" for the NHS, as some would require more extensive treatment as a result, he said.

The NHS's deputy chief executive, David Flory, wrote to NHS providers last month warning them to improve "unacceptable" performance on the 18-week limit, after 47 trusts missed one or both targets involved and 32 did not meet the requirement to treat 95% of emergency patients within four hours of their arriving at A&E. New NHS data out later this week, and the latest quarterly NHS performance monitoring report from the King's Fund thinktank, are expected to cast further doubt on promises – also made by the health secretary, Andrew Lansley – to keep waiting times low.

The Department of Health denied that waiting times were becoming a problem. "Waiting times are low and have been broadly stable since 2008. The latest figures show that 90.5% of admitted patients and 97.5% of non-admitted patients started treatment in under 18 weeks," said a spokeswoman.

Contributors

Denis Campbell and James Ball

The GuardianTramp

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