Public Audit Committee expresses concern over NHS waiting list times


Holyrood’s Public Audit Committee has expressed concern that some eligible patients in Scotland are not being treated in accordance with the NHS’s Treatment Time Guarantee (TTG), according to a parliamentary report published today. The Treatment Time Guarantee is a legal right to treatment within 12 weeks of treatment being agreed.

The report follows detailed scrutiny of the Auditor General for Scotland’s investigation into NHS financial performance and waiting lists. The Committee looked at the NHS’s performance in relation to the Patients’ Rights (Scotland) Act which legally guarantees the timescales within which patients can expect to receive medical treatment in hospital.

Public Audit Committee Convener Hugh Henry MSP said:

“Our committee has genuine concern that many patients in Scotland are not receiving the treatment they are fully entitled to receive within 12 weeks of their treatment being agreed.”

“We note the Scottish Government’s explanation that although patients have a legal right to treatment, for various reasons, 100 per cent compliance will be difficult to achieve. The Committee also notes that there have been improvements in waiting lists over the years.

“During the six months from 1st October 2012 to 31st March 2013 alone, there were 1,217 recorded breaches of the treatment time guarantee - that’s NHS patients not receiving the service to which they are legally entitled.  We have therefore called for the Scottish Government to explain how it will monitor and support the NHS to reduce these breaches.”

The Committee also registered its concern that due to delays in updating IT systems and implementing new guidance, national reporting on NHS waiting times associated with TTG has been insufficient to allow full scrutiny of health boards’ performance since October 2012.

The Committee acknowledges the Scottish Government’s confirmation that ISD (the NHS’s statistical body) will be able to provide this data from June 2014 (to be published from August 2014).

The Committee would therefore welcome confirmation from the Scottish Government on:

  • how it will use this information to assess and monitor boards’ performance on waiting times;
  • what support it will provide to any NHS board where performance issues are identified;
  • whether this information will also be retrospectively published to October 2012 to allow for trend analysis.

The Committee also seeks further information as to how the Scottish Government and NHS Boards will use the benchmarking tool to monitor and improve NHS Boards performance on waiting times.


In October 2012, the Patient Rights (Scotland) Act 2011 brought in the Treatment Time Guarantee (TTG). It is different from waiting time HEAT targets and standards in that eligible inpatients and day case patients have a legal right to receive treatment within 12 weeks of their treatment being agreed.  The Auditor General reported that boards are finding the TTG challenging with only three boards (NHS Orkney, NHS Western Isle and the Golden Jubilee National Hospital) meeting the TTG each month since its introduction.

Since December 2011, NHS boards have been required to meet the 18-week referral to treatment standard (RTT standard). The standard is for 90 per cent of patients to have started treatment within 18 weeks of being referred to hospital, including any outpatient appointments and diagnostic tests.

Since March 2010, no patient should have to wait more than 12 weeks for their first outpatient appointment (outpatient standard).

The Public Audit Committee’s report is titled: Report on NHS financial performance 2012/13 and Management of patients on NHS waiting lists - audit update.  It will be available on the Parliament’s website from 00.01hrs of Tuesday 3 June.

The Committee’s inquiry follows up on the Auditor General for Scotland’s reports NHS financial performance 2012/13 and Management of patients on NHS waiting lists – Audit update.

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