A study of waiting list accuracy at 41 NHS trusts found three trusts systematically and deliberately misreported their figures, while at more than half of the sites checked "problems with the information technology systems were identified as a contributory factor potentially leading to reporting errors".
The Audit Commission identified a range of problems. Some had ageing IT systems that simply could not meet reporting requirements. One trust has IT systems that were almost 20 years old. Others had systems that no longer receive technical support from the IT system supplier.
However, not all of the problems identified were due to old systems.
"In some cases," the commission noted, "new systems had been implemented and were yet to produce all the information required. In one example, a system was unable to re-adjust the dates for patients whose treatment was deferred or suspended and it was unable to remove patients treated as an emergency for the same condition as the one for which they were waiting."
Problems with IT systems were compounded by the spate of trust mergers in recent years and the subsequent difficulties in merging data from different systems. "Typically, this led to trusts running parallel computer and manual systems that increased the likelihood of reporting errors," the commission found.
The report identified a number of trusts as examples of best practice. The Nuffield Orthopaedic Centre, for example, has an IT system that automatically sends out letters to all patients at four-monthly intervals, checking their information and asking if they still wish to go ahead with their operation. Trust staff follow up patients who do not respond.
Epsom and St Helier Hospitals generate a weekly set of waiting list reports from their IT system, which ensure that appointments are made for patients approaching the maximum waiting time.
With the government about to pour billions into NHS IT, the Audit Commission recommended that "newly procured IT systems can cope with current reporting requirements and can easily be updated as clinical practice and reporting requirements change."