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Orthopaedics: Waiting Lists

Answer

[holding answer 15 November 2007]: The information requested is supplied in the following table.

	Wirral hospital NHS trust	Cheshire and Merseyside strategic health authority of residence	England
Operation description	Median time waited (in days)	Median time waited (in days)	Median time waited (in days)
Knee operation	162	164	168
Hysterectomy	59	57	66
Note:
Data provided is for mean and median ““time waited”” (in days) rather than ““waiting times”” where the main operation was a knee operation or hysterectomy (see footnotes for definitions).
Source:
Hospital Episode Statistics (HES)
Hospital Episode Statistics (HES) can only provide counts for ““time waited”” for all finished admissions within a given period. It is important to note that HES ““time waited”” figures are different to published waiting list statistics which count those waiting for treatment on a specific date and how long they have been on the waiting list. This elapsed time does not include any wait for referral to a hospital consultant. The data provided is only for elective admissions into hospital for the selected operation from a waiting list or booked elective admissions. The attached results excludes planned elective admissions and unlike published waiting list statistics are not adjusted for self-deferrals (e.g. if a patient deferred an operation as they were on holiday) or periods of medical/social suspension (please see footnotes for definitions of elective admissions from a waiting list, elective booked admissions and planned elective admissions). Note that finished admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
Operational Classification of Interventions and Procedures Version 4.2. (OPSC 4.2)
Knee Operation:
W40: Total Prosthetic replacement of knee joint using cement
W41: Total prosthetic replacement of knee joint not using cement
W42: Other total prosthetic replacement of knee joint
Hysterectomy:
Q07.1 Abdominal hysterocolpectomy and excision of periuterine tissue
Q07.2 Abdominal hysterectomy and excision of periuterine tissue
Q07.3 Abdominal hysterocolpectomy nec
Q07.4 Total abdominal hysterectomy nec
Q07.5 Subtotal abdominal hysterectomy
Q07.8 Other specified abdominal excision of uterus
Q07.9 Unspecified abdominal excision of uterus
Q08.1 Vaginal hysterocolpectomy and excision of periuterine tissue
Q08.2 Vaginal hysterectomy and excision of periuterine tissue NEC
Q08.3 Vaginal hysterocolpectomy nec
Q08.8 Other specified vaginal excision of uterus
Q08.9 Unspecified vaginal excision of uterus
R25.1 Caesarean hysterectomy
Data Quality
HES are compiled from data sent by over 300 national health service trusts and primary care trusts (PCTs) in England. The Department liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.
Elective admissions
An admission is elective if the patient has been waiting for treatment. There are three types of elective admissions. The above time waited data excludes planned elective admissions:
Elective admissions from a waiting list
Most elective admissions are from a waiting list, where the patient has been waiting for a hospital resource e.g. in this case a knee operation or hysterectomy.
Elective booked admissions
An increasing number of elective admissions are booked, where the patient was given a date at the time the decision to admit was made, determined mainly on the grounds of resource availability.
Planned elective admissions
A smaller group waits for clinical reasons, where the consultant has advised that the patient should return at an appropriate point when the body has had time for nature to take its course. For example, a patient whose broken leg was mended by means of a steel pin would return to hospital a few weeks later to have a pin removed. Or a cancer sufferer is invited for radiotherapy treatment in a sequence of measured doses, with necessary gaps between sessions for recovery and stabilisation.
Finished admission episodes
A finished admission episode is the first period of in-patient care under one consultant within one healthcare provider. Please note that admissions do not represent the number of in-patients, as a person may have more than one admission within the year.
Main Operation
The main operation is the first recorded operation in the HES data set and is usually the most resource intensive procedure performed during the episode. It is appropriate to use main operation when looking at admission details, eg. time waited, but the figures for ““all operations count of episodes”” give a more complete count of episodes with an operation.
Time Waited
Time waited statistics from HES are not the same as the published waiting list statistics. HES provides counts and time waited for all patients admitted to hospital within a given period whereas the published waiting list statistics count those waiting for treatment on a specific date and how long they have been on the waiting list. Also, HES calculates the time waited as the difference between the admission and decision to admit dates. Unlike published waiting list statistics, this is not adjusted for self-deferrals or periods of medical/social suspension.
Ungrossed Data
Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).

Secondary information

Type

Written question

Reference

467 c617-8W; 164669

Session

2007-08

Subjects

Waiting lists Orthopaedics Hysterectomy

Link

View this Written question on www.publications.parliament.uk