Coding error responsible for health board under-reporting hospital waiting list figures

Hayley Jones

A new report has confirmed that a health board under reported its hospital waiting list over several months due to a coding error.

A review into the issue published today highlighted governance shortcomings that allowed the error to go unnoticed, impacting the official statistics.

Cabinet Secretary for Health and Social Care Jeremy Miles confirmed that patient care was not disrupted and that the error related to reporting processes rather than treatment.

Data coding error

The under-reporting was traced to a generic clinician code, CONSG, which is used when the lead clinician for a patient’s pathway has not yet been identified.

As part of a national initiative to expand access to first outpatient appointments, many patient pathways were transferred to this code and appeared in daily and weekly management reports.

However, the code was mistakenly omitted from month-end RTT reporting, leaving pathways uncounted in official statistics between April and September 2025.

The discrepancy was discovered when teams compared weekly operational data with monthly national figures. Once the missing pathways were reintroduced into reporting in October 2025, the temporary spike in numbers prompted further investigation.

Some pathways relating to early pregnancy assessment units, same-day emergency care, and trauma clinics were initially included in RTT statistics but later corrected, as these relate to non-elective care and are not normally counted.

Waiting lists revised

Revised data for April to November 2025 were processed and validated by Digital Health and Care Wales, allowing publication to resume on 13 January 2026. Regular monthly RTT reporting resumed on 22 January 2026, bringing official figures up to date.

Across Wales, total patient pathways waiting in August 2025 increased from 790,576 to 795,360 after revisions. Pathways waiting more than 52 weeks rose to 158,748, an increase of around 2,560, while those waiting more than 104 weeks increased by 145 to 8,848.

Within BCUHB, the changes were proportionally larger.

In August 2025, total pathways waiting rose from 199,131 to 203,915. Pathways waiting more than 52 weeks increased to 54,404, and those waiting more than 104 weeks rose to 5,610.

Governance changes

The review identified weaknesses in governance and quality assurance within the health board, including limited reconciliation between operational and information teams, immature validation processes, and gaps in executive oversight.

Jeremy Miles said: “Patient activity was recorded accurately within the Patient Treatment List at all times, with no impact on patients’ treatment.”

In response to the error Betsi Cadwaladr University Health Board has strengthened its governance framework, introduced improved reconciliation templates, validation checks, and executive sign-off procedures.

The Office for Statistics Regulation endorsed the actions, allowing official statistics to resume publication.

The report recommends national changes across NHS Wales, including developing RTT data governance standards, improving system-level checks to detect anomalies, and adopting near-daily internal validation across all health boards.

Updated figures for BCUHB and the rest of Wales are scheduled for publication on 19 March 2026.