Image source, PA

A new initiative aimed at cutting NHS waiting times has been announced by the Scottish government.

The move will see a group of experts help health boards improve the management of planned operations and outpatient appointments.

It was announced as statistics showed an increase, external in the number of people waiting too long for treatment.

The data showed that the 18-week referral to treatment target was met for 84.8% of patients in June.

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Labour MSP David Stewart points out waiting times are always difficult for patients.

Mr Stewart says many people feel let down by the system.

He argues that behind every delay is an individual often suffering anxiety, pain and distress.

The Labour MSP points out a case of an octogenarian having to wait 11 months for a cataract operation.

Ms Campbell says the £200m to be invested in elective centres will take some pressure of waiting times.

The Scottish government will listen and respond to constructive concerns about the NHS, the minister says.

She criticises Labour MSPs for not bringing forward remedies to concerns.

Image source, PA

Last November we reported that the number of Scottish NHS patients waiting longer than 18 weeks for treatment to begin has reached its highest level in six years.

The figures, external showed that just 81.4% of patients met the referral to treatment target in September.

This was below the 90% goal set by the Scottish government - and the worst performance since the target was introduced in 2011.

There was also a big rise in people waiting for key diagnostic tests.

And the number of people waiting more than the 12 week target for outpatient appointments, and for inpatient and day case treatment, has also increased over the past year.

• Waits for cancer care, A&E and ops worsen across UK
• Check NHS cancer, A&E and operations targets in your area

Public Health Minister Aileen Campbell highlights the challenges the NHS and society now face.

Ms Campbell argues the Scottish government is meeting these challenges by investment and reform.

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The minister accepts that sometimes things fall below the standards we expect, as evinced by today's contributions in the chamber.

This will be advised in the revision of the Charter of Patient's Rights and Responsibilities and its guidance, she points out.

Closing for the Scottish Conservatives, Brian Whittle MSP says NHS boards must communicate accurate waiting times to patient.

Confirming his party will back Labour's motion, he argues it should not take an opposition debate to get across such a fundamental principle.

We do need to address waiting times and we could have been debating how best to do that, he says.

Instead Labour has had to use a debate to discuss an issue the Scottish government has already agreed to in law, Mr Whittle states.

The fact that it had to be raised should be of concern to all, he concludes.

Last November the chief executive of the NHS in Scotland, Paul Gray, said sorry to those patients who have had to wait longer than they should for treatment.

He made his apology during an evidence session to MSPs on Holyrood's health committee.

Last week watchdog Audit Scotland reported that the Scottish NHS had met only one of its eight key waiting time targets last year.

MSPs also heard from Scotland's Health Secretary Shona Robison.

She said she wanted all patients to be treated quickly and efforts were being made to improve the system in order to cut the amount of time patients wait.

• Look back on Paul Gray's evidence to Holyrood's health committee

Lib Dem MSP Alex Cole-Hamilton tells the chamber of an elderly constituent who was suspected of having mouth cancer.

The communication she received telling her it would be nine months before she could be seen indicated at the top that the letter itself had been delayed by two months, he reveals.

Expectation management is key Mr Cole Hamilton says, arguing patients will tolerate delays if the NHS is transparent about them.

Targets in the health service should take into account the bigger picture and not just focus on "thin slices" of a process.

Sir Harry Burns, Scotland's former chief medical officer, had been tasked with reviewing the issue.

In his report Targets and Indidicators in Health and Social Care in Scotland, external, he described some targets as "heavy handed".

The Health Secretary Shona Robison welcomed the review - saying targets needed to remain in place but they had to be more sophisticated.

The Scotsman reported that Sir Harry Burns said a flagship NHS guarantee which enshrines patient waiting times in law was a mistake.

His report says his report calls for a broader approach to healthcare and understanding what makes people unwell in the first place, rather than just focusing on narrow targets.

Read more of the Scotsman's article here., external

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Scottish Green MSP Ross Greer agrees the majority of people do receive treatment in 12 weeks, but adds this is far from the reality for everyone.

Severe delays have an impact on those who have to wait, Mr Greer adds.

The Green MSP cites a case where a patients had to wait nine months for an operation, with the anxiety being increased because the person was originally reassured they would be seen within four months.

He calls for money to be well spent in the NHS and to ensure it matches demand.

Under the referral to treatment standard, a least 90% of patients should receive all of the following within 18 weeks of being referred to a hospital:

• an outpatient appointment
• diagnostic test (if required)
• treatment (if appropriate)

Image source, SPL

The 90% target has not been met since July 2014, with a steady decline in performance recorded since then.

Health boards are also required to ensure that patients are seen at an outpatient appointment within 12 weeks of receiving a referral.

And patients needing one of eight key diagnostic tests, including checks for cancer, should receive the test and their results within six weeks of referral.

As well as these standards, the Patient Rights (Scotland) Act 2011 sets out a 12 weeks legal guarantee for inpatient and day case treatment.

The latest figures reported in the BBC:

• 69.7% of patients had been waiting 12 weeks or less for an outpatient appointment - ten percentage points lower than the same month last year.
• 80.2% of people waiting for inpatient and day case treatment were seen within the legal 12 weeks - a drop from 89.0% last year

Image source, Thinkstock

"The treatment time guarantee has failed so many patients in Scotland," states Mr Briggs.

Clinicians want to see a focus on best outcomes and ensure all patients are communicated with on a transparent basis, he argues.

Mr Briggs demands a total improvement and renewed focus on patients recieving the treatment they need.

They need to be given realistic waiting times, he concludes.

Tory MSP Miles Briggs says the SNP's rhetoric on the NHS has failed to match reality for day care patients.

One fifth of all eligible patients are having to wait more than 12 weeks, he claims.

NHS Lothian is the worse performing in Scotland on this, reflecting wider problems with capacity in the health board, Mr Briggs argues.

The Tory MSP takes the failure to put in place a proper workforce plan as the thread that runs through NHS failings.

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Ms Robison goes on to agree that communication with patients is crucial and says this will be improved by the Charter of Rights and Responsibilities.

The health secretary highlights £200m ear-marked for the lifetime of this parliament to be invested in the expansion of the elective capacity for routine operations.

Ms Robison says honesty goes both ways, criticising Labour for misrepresenting a report from cancer clinicians last week.

The health secretary insists the 31 weeks and 62 weeks waiting time targets are being retained as the report makes clear.

She points out that clinicians were very angry this report had been misrepresented by Labour, quoting disappointment from a cancer doctor.

Health Secretary Shona Robison accepts some standards have not been met.

However, she highlights nine in ten people - roughly 1.5 million patients - have been treated within the target since the introduction of the 12 week guarantee.

The Scottish government is committed to shifting the balance of spend away from acute settings and towards primary care, Ms Robison says.

The minister also confirms she had told all health boards that excessive waits must be eradicated.

Regarding communication with patients, she says boards have a duty to make it clear to patients they are covered by the guarantee but they are also meant to be kept informed of any delays.

Every single day, individuals are being "let down and left in limbo", Scottish Labour's health spokesperson says.

He raises the case of one of his constituents waiting for orthopaedic surgery, who was told in a letter there was a 12 week waiting time guarantee.

After those 12 weeks passed with no word, the patient was then informed the real wait could be 40 weeks, Mr Sarwar reveals.

Nearly 100,000 patients will have received similar letters and false hope, he states.

"A breach of a guarantee and a breach of trust."

He welcomes the Scottish government's commitment to be more honest with patients in communications in the future.

However, the Labour MSP argues that if the NHS was not failing patients the Scottish government would not have to alter guidance on communications in the first place.

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Labour MSP Anas Sarwar asks: "When is a guarantee not a guarantee?"

Mr Sarwar answers his own question: "Apparently when this government and this health secretary gives you one."

Scottish Labour's health spokesperson tells the chamber tens of thousands of Scottish patients are waiting much longer than the 12 week guarantee Shona Robison and Nicola Sturgeon gave to them.

The waiting times guarantee has been breached 120,000 times, he outlines.