Referral-to-Treatment for Surgical Carpal Tunnel ... - 18 Weeks

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Musculoskeletal Audit (MSk) - Carpal Tunnel Surgery If patients had Nerve Conduction Studies and were then reviewed by a further Outpatient Appointment, the average time from NCS to the review OPA was 8 weeks (median 6 weeks), and this varied between 4 and 14 weeks between hospitals. 92% of patients had their review OPA within 15 weeks of NCS, but this varied from 64% to 100% between hospitals (Fig. 14). Fig. 14: Time to post-NCS review Percentage of patients 100 80 60 40 20 0 Wishaw GRI/Stobhill DGRI/Garrick QMH/Victoria Elgin Borders Ninewells/Stra RAH/VOL ARI/Woodend Perth Monklands Hairmyres St Johns/RIE Raigmore IRH/Dunoon Forth Valley All patients 0-5 weeks 5-10 weeks 10-15 weeks >15 weeks There are also large variations in the time taken from NCS to subsequent outpatient review (Fig. 14). This is again a significant delaying point in the patient pathway. Some delay will occur whilst reports are prepared by neurophysiologists, and there may be further delay whilst patients are booked back into a clinic to be given their NCS results. Delay in this stage of the pathway is probably multifactorial, a combination of administration delays and trying to slot patients into already heavily booked clinics. - - 14
Musculoskeletal Audit (MSk) - Carpal Tunnel Surgery E) Surgery 82% of patients were operated on within 15 weeks of being added to the theatre waiting list (Fig. 15). However, 26% were in the period from 10-15 weeks, a substantial chunk of the future 18-week RTT target period. At the beginning of the audit period the target time for the whole period from diagnostic to surgery was 15 weeks, but this reduced to 12 weeks in March 2010. Fig. 15: Length of time to surgery after being added to the theatre waiting list Percentage of patients 100 80 60 40 20 0 Wishaw GRI/Stobhill DGRI/Garrick QMH/Victoria Elgin Borders Ninewells/Stra RAH/VOL ARI/Woodend Perth Monklands Hairmyres St Johns/RIE Raigmore IRH/Dunoon Forth Valley All patients 15 weeks Missing data Fig. 15 includes all patients irrespective of any reason for delay. Table 4: Average component times from Decision for Surgery to Date of Surgery Time from last OPA/diagnostic to date added to theatre waiting list** Time from being added to theatre waiting list to first theatre date booked % not operate d on at first theatre date booked Time from first date offered to actual theatre date N Mean % > 8 Mean % > 8 Mean % > 8 N N (weeks) weeks (weeks) weeks (weeks) weeks Wishaw 27 0.0 0% 27 8.1 37% 7% 27 0.1 0% GRI/Stobhill 65 0.7 3% 66 9.5 61% 6% 66 0.6 2% DGRI/Garrick 64 0.0 0% 65 8.8 29% 11% 65 0.7 3% QMH/Victoria 79 0.0 0% 79 8.2 58% 13% 79 0.9 5% Elgin 25 0.8 3% 30 7.4 40% 7% 30 0.1 0% Borders 62 0.0 0% 62 9.4 55% 16% 62 0.6 0% Ninewells/Stracathro 83 0.2 1% 84 9.2 55% 18% 85 1.2 6% RAH/VOL 79 0.5 4% 80 8.0 56% 20% 80 2.6 9% ARI/Woodend 65 0.6 3% 66 12.1 76% 0% 66 0.0 0% Perth 21 0.7 5% 21 12.6 90% 10% 21 1.7 10% Monklands 42 0.3 2% 43 6.9 35% 2% 43 0.3 2% Hairmyres 100 1.0 6% 101 8.8 48% 1% 101 0.1 0% St Johns/RIE 152 0.1 0% 150 14.2 85% 14% 150 1.8 5% Raigmore 61 0.3 0% 63 9.4 73% 6% 63 1.0 3% Inverclyde/Dunoon 47 0.0 0% 47 6.9 36% 17% 47 1.3 4% Forth Valley 52 0.5 2% 54 10.1 72% 28% 54 2.2 7% All patients 1046 0.4 2% 1040 9.7 59% 12% 1042 1.0 3% * Data omitted if based on fewer than 5 patients; sample sizes vary between columns due to availability of data ** Includes patients who went straight to theatre waiting list following their initial Outpatient Appointment. Some patients were added to the theatre waiting list before their final diagnostics result was available and are included above as being added immediately - - 15
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Page 3 and 4: A) Summary of overall period from R
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Referral-to-Treatment for Surgical Carpal Tunnel ... - 18 Weeks

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