Children are waiting weeks or months for key diagnostic tests as Merseyside NHS trusts record some of the longest waiting times in England.
The NHS constitution says patients should wait less than six weeks for tests like MRIs, CT scans non-obstetric ultrasounds, and heart and lung function tests. This is to help achieve the goal of every patient starting treatment within 18 weeks of a GP referral, a goal missed in many Merseyside hospital departments.
Trusts' performance on the six-week target for 15 key diagnostic tests is recorded each month on NHS England's website. In October, the latest month for which data is available, more than a quarter, or 27%, of patients on the waiting list for these tests at Alder Hey Children's Hospital were waiting more than 13 weeks. This made it the worst performing NHS trust in Merseyside on this measure, and the eighth worst trust in the country.
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More than a third, or 35.9%, of the 532 Alder Hey patients waiting for such tests were waiting more than six weeks. This was the 33rd highest level in England and the third highest in Merseyside, but a spokesperson for the hospital said many of its diagnostic services met the six-week target for all tests in November.
They said: "There are robust plans in place to reduce the waiting times for all diagnostics tests to below six weeks by April 2023. Many of our diagnostic services, such as radiology, are already providing all tests within 6 weeks in November.
"Diagnostic tests in other services, such as urodynamics and respiratory physiology, have increased their capacity to reduce waiting times. Our teams are also working on new and innovative initiatives which will increase capacity and reduce our waiting times."
The share of patients waiting longer than six weeks was even higher at Wirral Community Health and Care, which only offers one of the 15 diagnostic tests, the echocardiogram. More than two thirds of patients - 373 of 557 - waited longer than the target, making it the second worst performing NHS trust on this measure in England that month. The trust blames this on an increase in referrals and reduced capacity for specialist technicians nationally.
More than 23% of patients on the waiting list were waiting more than 13 weeks, the 16th highest in England and the second highest in Merseyside. A spokesperson for Wirral Community Health and Care, which runs walk-in centres and a minor injuries unit, said the trust's performance on echocardiogram waiting times does not reflect the trust's wider performance.
When asked if it had data to show better performance in other tests or areas, a spokesperson for the trust said it would take too long to find. The foundation trust's spokesperson told the ECHO: "This data reports on one diagnostic test only - echocardiogram - carried out by the trust and does not reflect the wider trust performance.
"Access to our community cardiology services has returned to pre-pandemic levels and we are committed to ensuring our patients and service users receive the best possible care. We acknowledge that patients referred for an echocardiogram diagnostic test are experiencing a longer wait time than expected.
"This is due to a combination of an increase in referrals and reduced capacity nationally of cardiology diagnostic technicians. We are working with partners across Cheshire and Merseyside to address this with an improved position by the end of the financial year."
While Wirral Community Health and Care was the second worst in England, Liverpool Women's Hospital had the second highest proportion of patients waiting longer than six weeks in Merseyside. Ranking 31st nationally, 38% of patients had been on the waiting list for more than six weeks.
Unlike many other trusts were the six-week target was missed for a high share of patients, few at the Women's Hospital waited longer than 13 weeks. Just over 8% did so, giving it a rank of 72 out of 155 NHS trusts in England. A spokesperson for the hospital said it has brought down its waiting times since the October data was collected.
They told the ECHO: "Like many NHS providers, Liverpool Women's NHS Foundation Trust has faced significant challenges as a result of the Covid-19 pandemic which has impacted on clinical capacity and diagnostic waiting times.
"Patients are clinically assessed to ensure that those who urgently require a diagnostic test, such as obstetric and cancer patients, are prioritised. This has led to longer waiting times for some routine diagnostic tests such as gynaecological scans.
"Following the introduction of an action plan to address this, an internal review in November 2022 has shown that our 6 week wait performance has improved to over 80%. This latest performance data will be published by NHS England in due course. We will continue with these improvement plans and expect to meet the NHS England target of 95% by March 2025."
The proportion of patients in England waiting longer than six weeks plummeted from around 45% in January 2007 to around 3% just over a year later. It stayed around that level until soaring in March 2020 as the coronavirus pandemic started, reaching a peak of 58.5% missing the six-week target by that May.
Although this has fallen since then, the share of cases where the target is missed is still around 10 times the pre-pandemic level. By the end of October, 426,003 patients in England had waited six weeks or more while 184,187 had waited 13 weeks or more. The NHS is opening 100 new community diagnostic centres to bring these numbers down, The Guardian reports.
Dr Katharine Halliday, president of the Royal College of Radiologists, said: "We weren't coping before covid, but the pandemic made it much worse. It is distressing for people to feel they are not offering a good service. Patients are waiting much longer, and most things get worse while you are waiting."
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