RCS urges NHS England to ban minimum waiting times as Lincolnshire patients face mandatory three-month wait for planned surgery

As reported in The Sunday Telegraph today, The Royal College of Surgeons (RCS) has called on NHS England to stop clinical commissioning groups from imposing minimum waiting times. A freedom of information request by the RCS found that certain patients in Lincolnshire must wait at least three months for non-urgent surgery under minimum waiting times rules imposed at some hospitals. 

NHS South West Lincolnshire Clinical Commissioning Group (CCG) has contractual agreements with three hospitals in its area stating patients cannot receive routine elective care before 12 weeks.  Surgeons are concerned that minimum waiting times will leave patients waiting in pain and discomfort for an unnecessarily long time and make it difficult for health providers to meet the Government’s 18-week target for planned surgery. The average waiting time for planned treatment in South West Lincolnshire was 7.6 weeks in December and the CCG is already missing the target to treat 92% of patients within 18 weeks. 

Wigan Borough CCG has also told the RCS minimum waiting times “will be a consideration as part of Wigan Borough Clinical Commissioning Group’s Transformation Programme.”  Late last year the Health Service Journal reported Trafford CCG was considering a similar move. 

The RCS is urging NHS England to make clear minimum waiting times are not permissible. The policy was previously banned by former health secretary Andrew Lansley¹, as well as in 2013 guidance to clinical commissioning groups², but appears to have been relaxed since.  Surgeons fear that if NHS England does not make clear that minimum waiting times are unacceptable, other clinical commissioning groups will very quickly begin to restrict access to surgery in the same way. 

All routine elective procedures excluding those that are clinically urgent or for cancer treatment fall within the contractual agreements NHS South West Lincolnshire CCG has with United Lincolnshire Hospitals Trust, Ramsay Healthcare, and the Orthopaedics & Spine Specialist Hospital.

Cambridgeshire and Peterborough CCG imposed a similar policy³ last year but reversed this following pressure from patient groups and clinicians, including the Royal College of Surgeons. The RCS says that under the NHS constitution there is a clear duty to ensure that treatment is provided to patients at the appropriate time in line with good medical practice and the National Institute for Health and Care Excellence (NICE) guidelines. 

In 2011 former Health Secretary, Andrew Lansley, banned Primary Care Trusts (PCTs) from imposing minimum waiting times for routine surgery following a Co-operation and Competition Panel report on patient choice in the NHS. 

Professor Neil Mortensen, Vice President of the Royal College of Surgeons, said:

“We strongly urge NHS South West Lincolnshire CCG to scrap its unfair minimum waiting time policy for planned surgery. Under this policy, patients will see their waits for planned surgery increase significantly, from a current average of 7 and a half weeks, to at the very least, the mandatory 12 weeks the CCG is imposing. It is difficult to see how the Government’s 18-week target for planned surgery could be met under this policy.

“The RCS recognises the significant financial pressures facing some CCGs. However introducing an arbitrary minimum waiting time for surgery is unlikely to save money in the long term and raises serious professional and ethical issues. Delaying elective treatment unnecessarily not only subjects patients to excessive pain and discomfort, but can also allow certain conditions to deteriorate, becoming life-limiting or even life-threatening. 

“NHS England should consider making clear that minimum waiting times are not acceptable. 

“Under the coalition government minimum waiting times were banned and we urge NHS England to reinstate that policy.”

Notes to editors

1. Andrew Lansley takes firm action to protect patient choice (Department of Health and Social Care press release, 14 November 2011): https://www.gov.uk/government/news/andrew-lansley-takes-firm-action-to-protect-patient-choice

2. NHS England Maximum Waiting Times – Guidance for Commissioners (19 August 2013): https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/08/wait-times-guid-comms.pdf (see page 12). 

3. Commissioners U-turn on controversial 12 week minimum waits (HSJ, 6 November 2017): https://www.hsj.co.uk/nhs-cambridgeshire-and-peterborough-ccg/commissioners-u-turn-on-controversial-12-week-minimum-waits/7020967.article

4. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

5. For more information, please contact the RCS Press Office
Telephone: 020 7869 6047/6052/6229
Email: pressoffice@rcseng.ac.uk
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