Shropshire NHS leaders accused of 'deliberately delaying patient care' over minimum 16-week wait

NHS Shropshire, Telford and Wrekin has introduced a minimum waiting time of 16 weeks for routine planned procedures, as part of measures being used by health boards across England to manage demand and control costs.

An investigation by the British Medical Journal (BMJ), using Freedom of Information data from 35 out of 36 integrated care boards (ICBs) in England, found that 17 ICBs had introduced minimum waits of between 12 and 16 weeks for key procedures.

Shropshire, Telford and Wrekin was among two ICBs – alongside West Yorkshire – to introduce a minimum wait of 16 weeks for all routine procedures.

Shropshire said it had “implemented a minimum waiting time threshold of 16 weeks” to “promote fairness, reduce variation, and ensure that all patients receive timely and equitable access to elective services”.

A spokeswoman from NHS Shropshire, Telford and Wrekin said its approach “is aligned with the NHS standard contract” and is intended to support progress towards the national target which says patients should wait no longer than 18 weeks from GP referral to treatment.

She said the “threshold does not apply to cancer or urgent referrals”, which continue to be prioritised in line with national targets set down by the NHS.

The findings come as the Royal College of Surgeons (RCS) said it was “concerned by the scale” of measures that can leave patients suffering in pain, while GP leaders said minimum waits were “difficult to justify”.

The Royal College of Surgeons of England president, Tim Lane, said: “We recognise the significant financial and capacity pressures facing the NHS, but patients who are clinically ready for treatment should not be deliberately made to wait. Unnecessary delays can prolong pain, limit mobility, increase anxiety and allow conditions to deteriorate.

“Access to treatment should be determined by clinical need, not where a patient lives. Widespread use of minimum waits risks creating a postcode lottery and further delaying care.

“Minimum waits are not a substitute for addressing the NHS’s underlying capacity problems.

“We need increased capital investment, improved infrastructure and better use of existing capacity so patients receive their treatment as promptly as possible.”

Professor Victoria Tzortziou Brown, president of the Royal College of GPs, said: “Long waits for hospital treatment can be frustrating for patients, particularly when they are living with pain or other symptoms that are affecting their day-to-day lives.

“During this time, patients often turn to their GP for support and ongoing management, so longer waits can also add to the already intense workload pressures facing general practice.

“We understand the enormous pressures facing hospitals and the capacity constraints that can lead to long waits, but decisions about when a patient receives treatment should be based on their clinical needs.

“Blanket minimum waiting times that require patients to wait longer than clinically necessary for administrative or financial reasons are difficult to justify, particularly where patients could otherwise be treated sooner.

“At a time when the NHS is trying to bring waiting times down, we should be doing everything possible to ensure patients can get the care they need without unnecessary delays.”

Sally Gainsbury, senior policy analyst at the Nuffield Trust think tank, told the BMJ: “Limiting activity by a certain minimum waiting time can be an equitable and rational response to making sure your budget is spread evenly across your population.”

But she added: “I’m concerned there isn’t clarity on how to do this fairly.”

An NHS spokesperson said: “While commissioned wait policies help the NHS make the best possible use of its services, staff and budgets – all patients are seen in order of clinical need.

“We recognise that any wait for treatment can be difficult for patients, and we would not expect any organisation to commission waits that risks breaching NHS Constitution standards, which set an 18-week maximum wait for elective treatment.”

The findings come as a national survey highlighted improvements in patient experience at The Shrewsbury and Telford Hospital NHS Trust (SaTH), which runs Royal Shrewsbury Hospital and Princess Royal Hospital in Telford.

SaTH’s overall patient experience score increased from 7.7 to 8.0 out of 10, with the trust moving from being rated “somewhat worse than most trusts” to “about the same as most trusts”.

The results showed improvements in areas including hospital admissions, confidence in doctors and support with basic needs, although the trust said there remained areas for improvement, including sleep quality and hospital discharge.