Thousands of patients not counted on waiting list data

Wales' largest health board under-counted the number of patients on its waiting lists by thousands over a five-month period, corrected figures have revealed.

More than 11,600 cumulative cases in north Wales were not recorded as waiting for planned treatment between April and August last year.

The revised figures were published following a review of data collection at Betsi Cadwaladr health board after inaccuracies were identified in November, prompting the publication of the health board's figures for the past two months to be suspended.

Chief executive Carol Shillabeer said lessons had been learnt by the health board, with processes for recording and reporting performance data strengthened.

Health Secretary Jeremy Miles said: "I want to be clear this was a data management issue and not a patient treatment issue. Procedures and processes have been tightened."

The review, set up by Miles, uncovered a failure to record private treatments paid for by the health board as part of a Wales-wide push to reduce the longest waiting times.

Weaknesses in the health board's quality assurance and oversight were also found to be contributory factors in the failure to detect the issue.

The corrected figures for north Wales show:

• A total 11,661 cases were not counted on waiting lists in the five months between April and August last year out of a cumulative total of about a million cases in the region during that period.
• That included 462 cases which should have been counted as waiting two years or more from a cumulative total of more than 29,300 between April and August
• But the figures still show that in October, Betsi Cadwaladr was responsible for roughly two-thirds of all patients in Wales facing the longest waits. Three years ago, the health board represented 25% of Wales' two-year waiting list.

For the first time in three months, waiting times across the whole of Wales have been made available.

The figures show there were just over 781,200 treatments waiting to be completed during the month - a drop of around 9,200 treatments from September.

Of those were 7,300 cases where a patient had been waiting more than two years - an increase of 655 (9.8%) from the previous month.

In England, two-year waits for consultant-led specialisms have almost been wiped out, with only 172 patients waiting that long.

There were also 141,500 patient pathways waiting more than a year in Wales, which is 20.2% of the waiting list, compared to just 2.3% waiting more than a year in England.

Because some patients are on more than one waiting list for different treatments, the actual number of patients waiting is estimated to be 599,841 - this is below 600,000 for the first time in more than 18 months.

Those waiting a year or more for their first outpatient appointment is now under 50,000 - half of what it was at the peak of the Covid aftermath.

Miles added: "There is more to do to reduce long waits, but I want to thank NHS staff for their continued efforts."

Plaid Cymru's health spokesperson Mabon ap Gwynfor said this was "nothing short of a scandal".

"The waiting lists statistics released over the last year were shocking enough, and now we find out they were understating the extent of the crisis facing our NHS," he added.

Shillabeer said: "The external review into the health board's referral to treatment (RTT) waiting time data identified a very specific reporting error that has now been rectified, and the amended information was resubmitted."

"It is important to emphasise that this issue has not affected patients receiving their appointments, nor has it impacted the delivery of care," she added.

So-called RTT waiting times are among the most closely watched figures produced by the Welsh government's statistics department.

They help patients, health staff and politicians understand how services are performing across Wales and are used to judge whether government-set targets are being met.

Last spring, Miles pledged that the total size of the waiting lists across Wales would be reduced from about 800,000 to 600,000 by the end of this March and that waits of two years or more would be eliminated across the country.

In a BBC Wales interview in November, NHS Wales chief executive Jacqueline Totterdell suggested Wales' biggest health board - Betsi Cadwaladr - would fall short of meeting that target.

The data mishap is the latest in a long list of problems linked to the health board, which delivers NHS services to a population of approximately 700,000.

Some critics claim the north Wales health board is too big to function effectively, and have suggested it should be broken up.