This is all-too-familiar to us here.

I’ve reported on NHS England re-starting the clock after A&E arrivals have been admitted to a department, to improve published statistics; on NHS Wales reducing targets from 95% for cancer waiting times, to 70%, to make things look less bad; on Public Health England not counting care home deaths to make their Covid death rate seem comparable to those in Scotland; on BBC UK using the ‘All’ A&E waiting time figures to compare with our ‘ED’ only performance to make theirs seem bearable and on English hospitals ‘coping’ with third world hospital-acquired Covid infection levels by just not publishing any, while Scotland had weekly returns in cleaner hospitals because Nicola Sturgeon had insisted on cleaning services staying in house.

That, above, is just from the top of my aging head. There’s more, no doubt. It’s cultural, in worlds where managerialism rather than professionalism and dependency on Tory bosses, sets the tone.

Today, even worse, this in the Health Service Journal:

Hospitals are being pressured to shift their resources to treating patients with less serious conditions to meet a “politically motivated” target, according to multiple senior sources.

The pressure appears to be coming through NHS England’s regional teams, with local sources saying they are being told to focus energies on patients in their emergency departments who do not need to be admitted to a ward.

These cases are typically faster to deal with, and therefore shifting resources to this cohort could significantly improve performance against the four-hour target.

However, experts in emergency care repeatedly warn that admitted patients are the most likely to suffer long waits and harm.

The NHS has been tasked with lifting performance against the four-hour target to 76 per cent in 2023-24, but has failed to meet that in any month this year. Performance in December was 69 per cent.

Before we get to the heart of this, it’s even worse – that 69% should be 55.4% for the full, consultant lead, A&E departments. Same ‘mistake’ again. It was 69.4% for all A&E departments including the wee ‘county’ hospitals typically hitting 95% in 4 hours with Elastoplast on sore knees.

Back to the heart of that above shocking news, redirecting from the most at risk to the less at risk for such cynical reasons is not new.

In February 2023, the Herald had this:

The ‘long-waiters?’ Yes, those not at death’s door but whom the media love to drool over and who worry politicians. The UK Conservative Government threw millions at the private sector to clear up the long waits while leaving those at risk of death and needing treatment within 18 weeks, to die. Proof below.

Scotland did not do that, leading some media to suggest we needed help from England to do the same.

From the BMJ on February 10 2023:

More than three million patients waited longer than 18 weeks for treatment in England in December, the highest number on record, show data for the NHS in England. In November 2022 a total of 2 902 274 waited 18 weeks or longer, and in December this figure rose to 3 051 661, the data on referral to treatment times show.1

https://www.bmj.com/content/380/bmj.p332

All things being equal, in December 2022, you’d expect Scotland to have 305 000 but in fact it had only 20 448 waiting over 18 weeks.

14.52 times more, per head of population, waiting longer than 18 weeks in England than in Scotland

Sources:

https://publichealthscotland.scot/publications/nhs-waiting-times-18-weeks-referral-to-treatment/nhs-waiting-times-18-weeks-referral-to-treatment-quarter-ending-31-december-2022

https://www.hsj.co.uk/emergency-care/exclusive-trusts-pressured-to-meet-political-target-by-diverting-staff-to-less-sick-patients/7036513.article

https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity