This report is intended to help the Commission for Healthcare Audit and Inspection (CHAI), as well as the NHS and the Department of Health, by summarising messages and lessons from all of our work in this area over the last three years. It includes the findings from the 2003 round of spot checks on waiting list and waiting time data.
The rules and definitions for waiting list and waiting times data need to be reviewed and updated to reflect new ways of working, such as booked appointments. The advent of booking (including e-booking) and patient choice makes this necessary, as waiting lists and times (as currently perceived and defined) will disappear. We consider that this should be a medium-term objective for the Department of Health, partly because of the complexity of the task, but also to ensure consistency of measurement for the 2005 NHS Plan targets.
Since we first commented on NHS data quality in the mid-1990s, NHS performance in this area has improved and the amount of effort and priority given to improving data and information quality, at both national and local levels, continues to increase. .
In some areas, specifically mental healthcare, there has been less progress than we would have hoped. For largely historical reasons there seem to be particular problems in this sector and there is an urgent need for focused action to improve the reliability of information.
Our experience suggests that, at a local level, corporate leadership on data and information quality is vital, but is not in itself enough. It has to be carried through into the everyday activity of staff at all levels. However, one of the biggest factors underlying poor data quality is the lack of understanding among frontline staff of the reasons for, and benefits of, the information they are collecting. The information collected is too often seen as irrelevant to patient care and focused on the needs of the 'centre' rather than frontline service delivery. In particular, more effort is needed to involve clinical staff in validating and using the information produced.
Improving data quality should therefore be linked inextricably to developing a wider strategy for specifying, obtaining and using information in the NHS at local and national levels.