Sufferers can wait weeks to hear if they can have a drug that is not routinely funded by the NHS – but The Herald has learned managers can wipe out this delay when they report their waiting-times figures. A file leaked to this newspaper also shows waiting-times data is adjusted to filter out delays caused by the failure of diagnostic tests and clinicians changing their minds about how a patient should be treated.
This new insight into the management of waiting-times results has emerged in the wake of the NHS Lothian scandal in which figures were fiddled in a bid to hit Scottish Government targets.
When the SNP was elected in 2007 it promised to bring more transparency to waiting-times information. The party set up a system where every patient referred to hospital has a ticking clock, monitoring how long it takes them to get treated. These clocks, however, can be frozen, reset or turned back if, for example, a patient fails to turn up for an appointment.
NHS staff who monitor waiting times,
called trackers, can check with a central team when they are unsure if they should make an adjustment. Last year, NHS Greater Glasgow and Clyde was permitted to adjust the clocks of patients who had applied for "off-protocol" drugs, saying they processed applications within 20 days.
Separately, NHS Fife was told it could remove the time it took to agree to fund the best treatment for kidney tumours.
Trackers have also been advised they can adjust figures when a diagnostic examination has failed so the data appears as if the test never happened.
Labour MSP Jackie Baillie said: "The more you dig, the more you discover the manipulation and fiddling of figures would appear to now be endemic across the NHS."
She added: "Audit Scotland's waiting-times investigation, with the support of PricewaterhouseCoopers, has delayed its report due to the complexity of the figures and delays in getting them from health boards. No wonder they're reluctant to provide information: the SNP claimed hidden waiting lists don't exist. They do and here is proof."
A Scottish Government spokesman said: "Cancer treatments are often complex and it is right we respect a patient's wish to consider their treatment options, including special requests for unlicensed medicines.
"The patient's treatment time clock is stopped to allow them to undertake their preferred treatment. However, this also means they can return to the original treatment programme should they wish."