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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 August 25; 335(7616): 365.
PMCID: PMC1952474

Thousands of patients wait more than 26 weeks for tests, as 18 week diagnostic target looms

Despite the imminent introduction of a target of 18 weeks between referral and treatment from 2008, almost 95 000 patients in England currently wait at least 13 weeks for diagnostic tests, and 66 000 patients wait more than 26 weeks, according to figures on a Department of Health

The five longest diagnostic waiting times (ranked by over 26 week wait)

Audiology is one of the worst specialties, with 55 376 tests still outstanding after 26 weeks. The department wants to reduce substantially waiting times for audiological tests. It says that complex cases should be referred to ear, nose, and throat clinics and that by December 2008 treatment should start within 18 weeks. By March 2008 patients routinely referred to audiology departments should be seen within six weeks, it says.

Ewa Raglan, a consultant audiovestibular doctor at St George's Hospital, London, and a spokeswoman for the Royal College of Physicians, is optimistic that this target can be reached, saying that the changes taking place within audiology are “encouraging and exciting.”

“I hope that the trained workforce, with proper clinical leadership, adopting new ways of working, will allow changes to take place by the proposed deadline.”

But the ear, nose, and throat consultant Adrian McCombe, from the British Association of Otorhinolaryngologists, is sceptical of the 18 week target for audiology. He says that streamlining referrals so that specialists see only complex cases will narrow the specialty and affect the training of specialist registrars. He added that the length of waiting lists in audiology was caused by the volume of referrals and lack of skilled audiologists.

“The majority of patients on the waiting list are elderly patients waiting for hearing checks and hearing aids. The reason the waiting lists are so long is the sheer volume of work. Audiology is a shortage specialty across the UK.”

Patients referred direct to audiology from their GP will not be included in the 18 week target, the Department of Health says. Dr McCombe says that this will skew the 18 week target figures because it does not take account of the number of elderly patients waiting for hearing aids.

Jonathan Fielden, chairman of the BMA's consultants' committee, said, “The fact that almost half of all patients are being treated in 18 weeks is encouraging and is a testament to how hard NHS doctors and other health professionals have been working. There is still a long way to go though to ensure that patients are treated as soon as clinically needed and for these improvements to be sustained.

“Consultants have demonstrated they can lead change and innovate new and efficient ways of caring for patients but many are still hampered from making further progress. Doctors were told earlier this year to ‘slow down,' and operations were cancelled so hospitals could balance their books. The government should free clinicians, GPs, and consultants to deliver the best value they can rather than fetter them with central targets.”


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