Elective Waits & Activity

This module contains visualisations which are based on a range of data which is constructed to provide clear and actionable insights into the activity of all aspects of Elective Waits & Activity.
Sources
NHS England Statistics

Elective Waits Initial Screen

The following visuals are available here which are all filtered by ICS, Trust, Specialty and Wait
Category –

 

• 3-Year Monthly Trend in New Elective Referrals to All Specialty(ies) For Trusts selected ICS (showing All)Trend in Elective Referrals and Waiting List for selected Provider and Speciality

• 3-Year Monthly Trend in Completed Elective Pathways for All Specialty(ies) at Trusts in selected ICS

• 3-Year Monthly Trend in Incomplete Pathways for All Patients at Trusts in selected ICS

• Incomplete Pathways for selected ICS/Trust by Selected Specialty Grouped by Wait Duration

• NHS Trust Pareto of Median Weeks from Referral to Admission for selected Specialty(ies) Highlighting selected ICS/Trusts

• 3-Year Monthly Trend in Incomplete Pathways for selected ICS/Trust/Specialty

Diagnostic Waits
Filtered by ICS, Trust, Test Type and number of years history –

 

• Pareto of Diagnostic Test Activity by selected Activity Type and NHS Trust for the required period at selected ICS
• Pareto of the Current Waiting List for Diagnostic Tests by Test Type at selected ICS
• Pareto of the Number of Weeks Waited to Date for Diagnostic Tests at selected ICS
• 3-Year Monthly Trend in the Number of selected tests Carried out at selected ICS
• 3-Year Monthly Trend in the Number of People Waiting for selected test at selected ICS

Diagnostic Imaging
Filtered by ICS, Trust, Body site/Modality, Test Type and number of years history –

 

• Diagnostic Imaging Activity by Test Modality for the selected period Stacked by Selected NHS Trust for selected ICS
• 3-Year Monthly Trend in Activity for selected tests at selected ICS showing selected trust
• 3-Year Monthly Trend in Median Request to Test Days for selected trust at selected ICS
• 3-Year Monthly Trend in Median Test to Report Days for selected tests by selected trust at selected ICS

Glossary Elective Waits & Activity
Term Meaning
Admission 

This is where the decision to admit could be separated in time from the actual admission, i.e. a patient whose admission date is known in advance thus allowing arrangements to be made beforehand.

Body site

Specific test conducted on a particular area of the body.

Clock Stopped 

In England, under the NHS Constitution, patients ‘have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible’. The NHS Constitution sets out that patients should wait no longer than 18 weeks from GP referral to treatment. A clock stop is the point that this time period is measure. It can be for various reasons –
For treatment when –
a) First definitive treatment starts. This could be:
i. Treatment provided by an interface service;
ii. Treatment provided by a consultant-led service;
iii. Therapy or healthcare science intervention provided in secondary care or at an interface service, if this is what the consultant-led or interface service decides is the best way to manage the patient’s disease, condition or injury and avoid further interventions;
b) A clinical decision is made and has been communicated to the patient, and subsequently their GP and/or other referring practitioner without undue delay, to add a patient to a transplant list.”
Or
For “non treatment” when –
An RTT clock stops when it is communicated to the patient, and subsequently their GP and/or other referring practitioner without undue delay that:
a) It is clinically appropriate to return the patient to primary care for any non consultant-led treatment in primary care;
b) A clinical decision is made to start a period of active monitoring;
c) A patient declines treatment having been offered it;
d) A clinical decision is made not to treat;
e) A patient does not attend their first appointment following the initial referral that started their RTT clock, provided that the provider can demonstrate that the appointment was clearly communicated to the patient .
f) A patient does not attend any other appointment and is subsequently discharged back to the care of their GP,
provided that:
i) the provider can demonstrate that the appointment was clearly communicated to the patient;
ii) discharging the patient is not contrary to their best clinical interests;
iii) discharging the patient is carried out according to local, publicly available, policies on does not attend.
iv) These local policies are clearly defined and specifically protect the clinical interests of vulnerable patients (e.g. children) and are agreed with clinicians, commissioners, patients and other relevant stakeholders.

Completed Elective Pathways 

Completed pathways – admitted patients

Referral To Treatment 

Waited times for patients whose clock stopped during the month with an inpatient or day case admission. or for reasons other than an inpatient or day case admission.


Current Waiting List 

A list of patients waiting to receive a consultative, assessment, diagnosis, care or treatment activity from an organisation.

Diagnostic Imaging

Diagnostic imaging describes various techniques of viewing the inside of the body to help figure out the causes of an illness or injury and confirm a diagnosis.

Diagnostic Test

A type of test used to help diagnose a disease or condition. Mammograms and colonoscopies are examples of diagnostic tests. Also called diagnostic procedure.

Diagnostic Waits The waiting times are for patients who have been referred for a test, but whose test had not taken place by the end of the reporting period.
History The number of years data to display.

ICS
Integrated care systems (ICSs) are partnerships that bring together NHS organisations, local authorities and others to take collective responsibility for planning services, improving health and reducing inequalities across geographical areas. England is split into 42 ICS’s.

Incomplete Pathways Referral To Treatment Time

Waiting times so far for patients whose clock is still running at the end of the reporting month. This is a ‘snapshot’ on the last day of the reporting period.
Or patients with a decision to admit for treatment
Or Referral to Treatment waiting times so far for patients whose clock is still running at the end of the reporting month for whom a decision to admit has been made.

Median Request to Test Days

The median is the value in the middle of a data set, meaning that 50% of data points have a value smaller or equal to the median and 50% of data points have a value higher or equal to the median. In this instance it is the middle number of days between the request for a diagnostic test and the date of the actual test.

Median Test to Report Days

The median is the value in the middle of a data set, meaning that 50% of data points have a value smaller or equal to the median and 50% of data points have a value higher or equal to the median. In this instance it is the middle number of days between the request for a diagnostic test and the date of the report.

Median Weeks

The median is the value in the middle of a data set, meaning that 50% of data points have a value smaller or equal to the median and 50% of data points have a value higher or equal to the median. In this instance it is the middle number of weeks between the date of referral and admission.

Modality 

Diagnostics include using testing and other procedures to arrive at a diagnosis for a particular disease or illness. A diagnostic modality is an method of examination to establish the cause of a person’s condition, disease, or discomfort such .as a mammogram or colonoscopy

New Elective Referrals 

Elective referral means referral by a general medical practitioner, general dental practitioner or optometrist to a health service provider for treatment that is not identified as being immediately required at the time of referral. In this instance this is new referrals made in the reporting period.

NHS Trust 

An NHS Trust is an organisation. An NHS Trust is a legal entity, set up by order of the Secretary of State under section 25 of, and Schedule 4 to, the National Health Service Act 2006, to provide goods and services for the purposes of the health service. A Trust is part of an ICS.

Number of people waiting 

The number of patients whose clock is still running at the end of the reporting month. This is a ‘snapshot’ on the last day of the reporting period.

 

Number of weeks waited

The amount of time so far for patients whose clock is still running at the end of the reporting month. This is a ‘snapshot’ on the last day of the reporting period.

Pareto

This is a chart type that are often used to identify areas to focus on first in process improvement. Pareto charts show the ordered frequency counts of values for the different levels of a categorical or nominal variable. 

Referral

Referral means referral by a general medical practitioner, general dental practitioner or optometrist to a health service provider for treatment that is not identified as being immediately required at the time of referred.


RTT (Referral to Treatment Time)

In England, under the NHS Constitution, patients ‘have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible’. The NHS Constitution sets out that patients should wait no longer than 18 weeks from GP referral to treatment. This term is an NHS one used to cover this timeframe.

Speciality Elective activity is split up into various Specialty codes which denotes which service is responsible for the patient for that element of care. As an example –

General Surgery
Urology
Vascular Surgery
Trauma and Orthopaedics
Ear Nose and Throat


Stacked by

A stacked chart is a form of bar chart that shows the composition and comparison of a few variables. In this instance the trust within a selected ICS are stacked on top of one another for each modality/body site.

Test Type

One of the key data items that the Diagnostic Imaging Dataset collects is information relating to the examination, i.e. the exam code. Trusts are required to use National Interim Clinical Imaging Procedure Codes or Systematized Nomenclature of Medicine Clinical Terms codes to identify the test type used.

Trend 

Trend charts are used to show trends in data over time.

Wait Category

Where the reporting is on incomplete or complete Pathways the Wait Category id split into those with a decision to admit and those without a decision to admit.

Wait Duration
In England, under the NHS Constitution, patients ‘have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible’. The NHS Constitution sets out that patients should wait no longer than 18 weeks from GP referral to treatment. In this instance we are reporting on the additional timescale of 19-52 weeks and Over 52 weeks.