MSPs call for more accurate NHS waiting time logs

The Scottish Parliament's public audit committee wants patient records to be checked regularly

A Holyrood committee has called for patient records to be checked every month following its investigation into waiting time data manipulation.

The MSPs said they had been unable to "draw firm conclusions" on whether waiting times targets had led to patients being marked as unavailable.

They said in future accurate reasons should be given for treatment delays.

The inquiry came after the NHS Lothian scandal over the use of "unavailable" codes in patient waiting list logs.

They were criticised for removing patients from the 18-week waiting list when they refused to travel to England for treatment, marking them as "unavailable for social reasons".

It also emerged that some staff at NHS Tayside said they felt under pressure to say patients were "unavailable" for appointments in order to meet waiting-times targets.

The Scottish Parliament's public audit committee suggested samples of patient records were tested to make sure the use of social unavailability codes on the NHS computer system was "appropriate".

'Target fixation'

Iain Gray, committee convener, said health boards "should have sufficient information to demonstrate that codes are being used for appropriate reasons".

The Labour MSP said: "Due to the lack of data in the audit trail on the use of codes, the committee is not in a position to draw firm conclusions on the extent to which codes have been applied as a result of capacity pressures in the NHS, or the extent to which reducing waiting time targets may have impacted upon the use of codes.

"This highlights the importance of ensuring accurate data is available in future to validate the positions of health boards and the government but, even more importantly, to ensure it reflects the experience of patients across the NHS."

Scottish Labour's health spokeswoman Jackie Baillie accused the SNP government of being fixated with targets instead of patient care.

She said: "There are still no answers on how widespread the misuse of social unavailability codes were in manipulating waiting times across the country.

"No rationale has been provided on why the use of codes fell dramatically, after the NHS Lothian debacle, a fact acknowledged by Audit Scotland and now this committee.

"The reality is that this scandal was part and parcel of the SNP's fixation on meeting targets rather than providing proper patient care."

Poor information

Public spending watchdog Audit Scotland conducted an earlier investigation into health boards, which it said had been hampered by a lack of information.

In its report on the wider status of waiting lists, it found the use of social unavailability codes, where patients are marked as unavailable for treatment if they cannot attend an appointment, increased from 11% in 2008 to just over 30% in 2011.

Audit Scotland concluded that in a small number of cases patients had been inappropriately marked as unavailable for treatment, but it could not say whether these were deliberate.

It stated: "Due to the poor information, it was not possible to determine whether these were due to human error, inconsistent interpretation of guidance, or deliberate manipulation."