Delayed referrals to treatment - Response of Barking, Havering and Redbridge University Hospitals Trust and NHS Improvement

Healthwatch Havering carried out a joint review, to examine the issues regarding the significant delays in the care of patients between January 2016 to March 2017. The work was done as part of the Joint Topic Group, formed by Healthwatch Havering and Havering Health Overview Scrutiny Sub-Committee, to examine the delays issue at Queen’s Hospital and King George Hospital.

This summary highlights the response receive from Barking Havering and Redbridge CCG (BHR CCG), Barking Havering Redbridge University Hospital Trust (BHRUT), and NHS Improvement (NHSI).

The CCG responded that they have a formal contractual mechanism in place, as a commissioner with BHRUT to oversee and monitor demand and capacity modelling for elective activity on a monthly basis. To address the delayed referral issue, the CCG and the Trust plan to develop a business case for the establishment of a referral management system.

The BHRU Trust responded that they are pleased to have an opportunity to response to the report. The Trust has recently hit the 92% Referral to Treatment incomplete standard for the first time in three years (June 2017), against a national picture of stagnating or declining performance. This follows the success of the major recovery programme undertaken at the Trust, in partnership with GP commissioners. The following achievements were made:

• At beginning of 2014, waiting list included over 1,000 people waiting longer than 52 weeks – now down to a very small number

• Thousands of extra clinics and nearly 100,000 appointments delivered, with thousands of patients redirected by GPs

• June performance saw BHRUT exceed national average (90.3%)

• Less than 8% of patients waiting longer than 18 weeks for June

NHS Improvement responded that BHRUT has developed and implemented a recovery plan which has seen it make significant progress against the Referral to Treatment (RTT) national standard including reporting compliance against the standard in June 2017 - three months ahead of plan and for the first time in three years. The trust has also made significant progress in strengthening organisational oversight and governance systems and processes. NHS Improvement will continue to monitor the trust’s performance against the national standard to ensure the necessary level of assurance that the trust is continuing to deliver timely care for patients.

The response report does not make recommendations.