SNP rapped over 'misleading' patients on waiting times

However, concerns have been raised that very lengthy waits are missing because the figures only include the waiting time for patients who were treated in the most recent quarter. By definition, these are people who were prioritised for an operation.

Patients who are considered less urgent and who are still on a waiting list - potentially waiting for months or even years - are therefore absent from the NHS Inform dashboard.

For example, in the most recent quarter - April to June 2022 - the dashboard states that 2,042 people had orthopaedics surgery within Scotland's largest health board area, NHS Greater Glasgow and Clyde, with a median wait time prior to treatment of 28 weeks. 

However, data from Public Health Scotland also shows that there were more than 13,000 patients on waiting lists for orthopaedic surgery in NHS GGC as of June 30 this year, of whom 1,005 had already been waiting over two years.

The dashboard statistics were previously branded "pure fantasy" by surgeons, who said it was also leading to clashes with some patients angry to be told that they would face much longer waits than they had expected.

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In a letter sent to officials at the Scottish Government and Public Health Scotland, Ed Humpherson, the director general for regulation at the UK Office for Statistics Regulation, said the data could mislead the public.

He wrote: "The NHS Inform dashboard shows the numbers of patients treated in the last quarter and their median wait times by clinical specialty.

"However, patients who have not yet been treated, some of whom may have been waiting a long time, are not included in these statistics.

"The dashboard could potentially mislead some patients about the length of time they may have to wait.

"For example, in some specialties, those with non-urgent clinical needs may experience a much longer wait than is suggested by the figures.

"We have heard that there have been instances of conflict between patients and surgeons in the orthopaedics specialty around the realistic lengths of time patients should expect to wait.

"These statistics are of high public interest in Scotland, particularly in the aftermath of the pandemic.

"We welcome the development of a dashboard to make these statistics accessible to patients. However, it is important in developing dashboards that the principles of intelligent transparency are followed."

Mr Humpherson added that it "can be difficult to find the source of the data and to understand the methodology choices and data limitations", with "no easily locatable link" on the dashboard where website users can see the relevant statistics by NHS health board on the numbers of people still waiting for orthopaedics procedures for example - including the numbers waiting over one or two years.

He has made a number of recommendations, including calls to "prominently highlight the strengths and limitations of the statistics for the purpose of giving an indication of a patient’s typical waiting time for planned care" and to "consider publishing a range of statistics on the waiting times for each specialty and local area to reflect the range of waiting times experienced by patients".

He added that, on the latter point, "we understand that plans are currently underway for this".

A Scottish Government spokesman said: “We have received the letter from the UK Statistics Authority and we will continue to work with Public Health Scotland to review and address the key points raised. We are regularly engaging with users to gather feedback and improve the online site.  

“We will consider what additional metrics can be added as part of that review to ensure we are representing the range of waiting times experienced by patients as some will wait shorter than the median, and some will wait longer.”

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It comes after questions were also raised over how comparisons are made between Scotland and England's emergency performance. For example, Scotland's emergency departments - larger clinician-led A&E departments - tend to outperform equivalent units in England on the four-hour target for patients to be seen, treated, and subsequently discharged, admitted or transferred.

However, if the comparison is made with overall A&E departments - including minor injury units and smaller community hospital casualties - then England's performance in recent months has been slightly better than Scotland.

Scottish Labour leader, Jackie Baillie, who referred concerns over the NHS Inform dashboard to the UK statistics regulator in October, welcomed its response.

She said: “Try as they might to spin the stats, the truth is plain to see – this SNP government is crashing our NHS.

“From massaging A&E figures to misrepresenting waiting times, there is nothing that this SNP government will not stoop to in order to hide their failures.

“The people of Scotland can see that this is a do-nothing Health Minister who is presiding over chaos in our NHS.

“It’s time for Humza Yousaf to drop the spin and face the music.”

Elective activity (grey shaded area) remains well below pre-pandemic averages (Source: Public Health Scotland) (Image: PHS)

It comes as the latest figures for elective activity show that the number of planned procedures carried out on NHS Scotland fell to 20,608 in September - down from 21,218 in August. 

It also compares to an average of around 25,000 for the same month pre-pandemic - meaning that elective activity remains around 18% lower than it was before Covid. 

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In 2021, the Scottish Government's five-year NHS Recovery Plan - published before Omicron - envisioned a substantial increase in elective activity during 2022/23 which would have seen the number of planned procedures carried out exceeding pre-pandemic levels by 10% as part of efforts to clear the waiting list backlog. 

The Scottish Government has blamed successive waves of Covid during 2022 for slowing the recovery.  

Overall, NHS Scotland has performed a total of 115,415 elective procedures to date in 2022/23 - the period covering April to the end of September. 

This is an increase of 6.2% compared to the same period in 2021/22, when there were 108,726 planned procedures carried out, but is 24% lower than April-September in 2019, before the pandemic, with 152,220 procedures. 

A report from Public Health Scotland in October also revealed that, as of September 30, there were 7,650 patients on waiting list for an inpatient/day case procedure on the NHS who had been waiting over two years. 

This had reduced from 10,066 at the end of June 2022. 

However, the Scottish Government had set a target to eradicate such long waits for most specialties by the end of September 2022. 

The health boards with the largest number of two-year wait patients still on their lists as of September 30 were NHS Grampian (2,120 patients), followed by NHS GGC (1,758) and NHS Lothian (1,098).

Only one territorial health board - NHS Dumfries and Galloway - had no two-year wait patients still on its lists.