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

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Summary of report content

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.

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General details

Report title 
Delayed referrals to treatment - Response of Barking, Havering and Redbridge University Hospitals Trust and NHS Improvement
Local Healthwatch 
Healthwatch Havering
Date of publication 
Thursday, 30 March, 2017
Date evidence capture began 
Sunday, 1 January, 2017
Date evidence capture finished 
Thursday, 30 March, 2017
Type of report 
Key themes 
Quality of appointment
Quality of care
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
How was the information collected? 

Details of health and care services included in the report

Secondary care services 
Acute services without overnight beds / listed acute services with or without overnight beds

Details of people who shared their views

Number of people who shared their views 
Age group 
Specific ethnicity if known 
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 
Not known

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
What type of impact was determined? 
Network related impact
Tangible Impact (cost related)
Tangible impact (not cost related)

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.