Waiting times for mammograms and average length of delay

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WRITTEN QUESTION TO THE PRESIDENT OF THE HEALTH AND SOCIAL SERVICES COMMITTEE BY THE DEPUTY OF ST. JOHN

ANSWER TO BE TABLED ON TUESDAY, 9th NOVEMBER 2004 Question

Would the President advise members –

1. if delays are occurring for the scheduling of mammograms, the average length of delay and what action has been taken to notify the patients?
2. of the waiting time in other areas of medicine, i.e. orthopaedic etc. and would he advise members how patients are kept informed about the waiting times?
3. what plans the Department has to improve waiting times?

Answer

1. Patients present for mammography in three main ways –

Routine screening – women between the ages of 50 and 65 who have no symptoms of breast disease  either refer  themselves  or  are referred  by  their  General  Practitioner (GP) for  routine screening. Thereafter, they are called back every 2 years to check that they remain healthy.

Suspected cancer - GPs suspecting breast cancer refer patients to the Breast Unit who offer a mammogram as part of a specialist consultation.

`  Benign conditions - GPs suspecting a benign breast condition requiring investigation by mammogram refer directly to the Radiology Department.

At present, waiting times are as follows –

Routine screening – Around 600 women each year reach the age of 50 and become eligible for the screening programme. The U.K. standard is that they should have their first screening mammogram within the year. This standard in Jersey is always met and most patients receive their first appointment within a month of referral, but this can vary depending on whether referrals arrive in batches or are more evenly spread throughout the year. These women have no symptoms; thus there is no delay' for the initial referral to the routine screening service.

When patients are recalled after two years, their appointment time will not be exactly two years later but will vary up to two months from the anniversary of the initial date. This is not a delay' in scheduling but part of the cyclical management of the process to ensure a smooth workflow. The appointments being made last week (week commencing 1st November) are within 3 weeks of the 2nd anniversary of the original dates.

Suspected cancer – urgent referrals to the Breast Unit are often offered a mammogram the same day, the majority have their mammogram and first appointment with the consultant within one week, and none wait longer than two weeks either for a mammogram or to see the consultant. This standard is better than that which operates in the U.K.

Benign conditions – The current wait for mammography in the Radiology Department is one week.

Because there are no delays in any of the three elements of this service, it follows that no especial action is taken to communicate the "waiting time" to clients/patients.

2. Please find attached –

Appendix 1 - waiting times for routine outpatient appointments by doctor. Appendix 2 - waiting times for routine surgery by specialty.

These are the categories that are the focus of attention in the UK and are the usual subject of articles in the media.

Patients whose clinical condition has been assessed as urgent' or soon' will be seen and treated very much more quickly and in line with best practice for the particular problem.

The hospital sends out an advice of waiting times for routine outpatient appointments to GPs on a monthly basis, who advise patients accordingly.

Hospital doctors or nurses tell patients how long they are likely to wait for their operation directly at the time the decision is taken to list them for surgery.

Hospital waiting times are detailed below and key indicators are now published annually in the States of Jersey Benchmarking report, for example as shown in Appendix 2 below.

3. The President will be making an announcement about waiting lists within three weeks when negotiations – currently underway with senior clinicians - are brought to a conclusion by the Chief Executive and his senior colleagues.

Appendix 1  

Outpatient Waiting Times in Weeks

Appendix 2

Waiting Times for Routine Surgery by Specialty As at 29 October 2004