I am sure most waiting times trackers in NHS Scotland will have had to make adjustments to patient waiting list records which they have not been entirely comfortable with.
The pressure to make adjustments, such as marking people as socially unavailable for treatment, grows when patients are starting to breach waiting times targets. When hospital specialists, including people who deal with scans as well as surgeons and physicians, are away on holiday, that has an impact on things. Staff are uncomfortable raising queries about the way waiting times are adjusted or social unavailability codes are used. There has always been a risk you will be strongly overruled, which makes you hesitant to raise certain issues in the first instance.
The waiting times scandal in NHS Lothian did not come as a surprise with any of my colleagues. If anything, the pressure on staff to make waiting list figures hit targets has increased since then. Management are still under pressure to do everything in their power to reach the treatment times targets and less money is available to provide hospital services.
Those of us in this field have often discussed the true purpose of waiting times, i.e to highlight shortfalls within the service. We all feel it is a wasted exercise as shortfalls are covered up by the adjustments and exclusions made if the patient pathways are complex.
"We feel the patient's journey should be the priority over waiting times.
The Government has not supported trackers or auditors in any extra way during the last two years as far as I am aware.
Health boards are constantly looking at savings so no extra resources or support have been made available.
Trackers are under pressure to ensure deadlines are met and every aspect of their work is under scrutiny.