Patients have had to wait 338 days for an MRI scan in Birmingham
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Some patients have had to wait nearly two years for hospital tests in North Staffordshire, according to a survey.
The Healthcare Commission awarded University Hospital the lowest possible grade for diagnostic tests.
Patients can wait between 10 weeks and nine months for a scan at two hospitals in Worcestershire, and nearly a year at University Hospital Birmingham.
The government target is a maximum 18-week wait from referral to treatment by 2008.
The commission looked at data up to the end of September last year and graded 153 acute hospital trusts across England as excellent, good, fair or weak.
The waiting times in Staffordshire are the worst in the West Midlands.
Patients who require a routine colonoscopy in Staffordshire - an internal examination of the large intestine - have to wait 665 days.
A spokesman from the hospital said the results were disappointing but they were working hard to rectify them. Currently, only four patients were waiting more than a year.
Worcestershire Acute Hospitals NHS Trust, which runs three hospitals in the county, said since September 2005, waiting times for MRI scans have been reduced.
Reduced waiting times
Currently, patients will be treated within 15 weeks at Worcester Royal Infirmary and Kidderminster General and just seven weeks the Alexandra Hospital in Redditch, with urgent scans being seen much sooner.
University Hospital in Birmingham and Walsall Manor in the Black Country were graded as fair.
The commission's statistics showed that the wait for a routine MRI scan in Birmingham was 338 days and over two years for a routine colonoscopy in Walsall. A spokesman from University Hospital said since the survey it has reduced MRI waiting times to 126 days.
Anna Walker, chief executive at the Healthcare Commission, said: "Some patients are still waiting too long for diagnosis, delaying their treatment, and too many internal examinations fail to achieve a result, slowing down diagnosis and causing distress to patients."