English NHS performs better than Scotland, Wales & Northern Ireland

In the National Health Service (NHS) today the vast majority of patients are treated within 18 weeks of referral by their General Practitioner (GP), an improvement of 8 weeks compared to 2006, when almost all patients were treated within six months. However today in:

  • Wales – 79% of patients wait longer than six months for treatment
  • Northern Ireland – 84% of patients wait longer than six months for treatment
  • Scotland – No comparable figures were available

The study illustrates that since devolution (see below) in 1999, when Wales, Northern Ireland and Scotland took control of their respective countries NHS, performance has been below that of England, in respect of waiting times at least.

The study, undertaken by Professor Nicholas Mays of the London School of Hygiene and Tropical Medicine covers the period 1996-97 to 2006-07. In respect of the Scottish National Health Service Professor Mays compared performance against the North East of England, which offers the most similar health care service. The study showed that in 2006 the Scottish NHS:

  • Spent 6% more per head
  • Had 14% more Doctors
  • Had 50% more Nurses
  • Had 75% more Managers
  • Treated 50% less in-patients
  • Treated 40% less day cases

The Director of the Nuffield Trust, Jennifer Dixon said ‘A key question for the NHS in all four countries is whether value for money is being obtained. Some of the differences reflect the greater pressure in England to improve performance via targets’

Devolution of the NHS

In 1999 Scotland, Wales and Northern Ireland assumed formal powers over their respective National Health Services. Although the countries quickly used their powers many decided to retain power centrally rather than devolve power further to local healthcare providers. This approach contrasted with England, where the Government gave more and more power to local Primary Care Trusts (PCTs) and Foundation Trusts (hospitals with more and more control over how they are operated).

The 18 Week Maximum Wait

The aim of the Maximum 18 Week Wait is to ensure that all patients receive high quality care without unnecessary wait; overall the NHS would like to ‘take waiting as an issue off the agenda for patients once and for all’.

18 weeks applies to routes of care (or pathways) that do or might involve Consultant led care. The policy sets a maximum of 18 weeks from the point of initial referral from a GP to the start of treatment. 18 weeks is considered to be ‘the length of time that patients see as an acceptable wait for non-emergency consultant-led treatment’. Overall the operational standards for delivery are:

  • 90% of pathways where patients are admitted for hospital treatment should be completed within 18 weeks, AND
  • 95% of pathways that do not end in an admission should be completed within 18 weeks

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