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Press release: NHS management responds to NAO report - Primary Care Trusts should be given responsibility for waiting lists

18 Dec 2001

The National Audit Office (NAO) report1 published today is a report into the actions a number of trusts took to meet waiting list targets. All individuals employed within the NHS have a duty, as guardians of public trust, to abide by the principles governing probity in public life and patients put their trust in these people. Both managers and clinical managers involved in these events have caused unacceptable distress to many patients, said Nigel Edwards, acting chief executive of the NHS Confederation.

None of these actions can be condoned, however, they do need to be put into perspective. In 1999/2000 there were 12.1 million new outpatient appointments and 31 million re-attendances. In the three years covered by the NAO report, the NHS saw over 34 million people for the first time - of these 94 per cent were seen within 26 weeks.

Nigel Edwards said, the NHS performance management system contains a number of perverse incentives that can lead to 'gaming' behaviour where people try to meet the targets at all costs. The Confederation has been arguing for some time that fundamental change of this system is necessary.

He continued, The NAO report focuses on how to pick up such behaviour once it has happened. NHS management has been arguing that there is a need to look to the future and change the way waiting lists are handled. One solution would be to give the new Primary Care Trusts (PCTs) responsibility for managing waiting lists2. PCTs can act as advocates of the patient and, have a strong incentive to ensure that individuals are seen appropriately. As the new commissioners of care, they can make individual decisions about where to send patients who have been waiting too long.

He concluded, NHS management agrees with the NAO that confidentiality agreements should not be used in cases where severance payments are made to individuals. We also agree that any severance payment should be clawed back should an individual be re-employed within the NHS.

-ends-

Notes for editors

1 Inappropriate adjustments to NHS waiting lists, National Audit Office,19 December 2001
2 An end to queuing, NHS Confederation June 2000

• The NHS Confederation is the voice of NHS management. Our members include the majority of NHS trusts, primary care trusts and health authorities in England; trusts, health authorities and local health groups in Wales; trusts and NHS boards in Scotland; and health and social services trusts and boards in Northern Ireland.
  

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