NHS waiting lists can be cut through 'radical' reform
Hospitals can cut waiting lists with radical steps to stop "over-treatment", the Wales Audit Office says.
It found 11% of patients were waiting longer than the 26-week target for non-emergency treatment in March 2014 and that targets were last met in 2010.
A report said "prudent healthcare" focusing on the minimum treatment needed could save time and resources.
Auditor General Huw Vaughan-Thomas said the NHS "will need to act strongly and bravely" to make meaningful changes.
He said: "We are clear in our findings; the current approach to delivering services does not deliver sustainably low waiting times.
"As I have highlighted before, there needs to be an open and honest discussion about the way services are delivered."
The report - NHS Waiting Times for Elective Care in Wales - called on the NHS and the Welsh government to "radically re-shape" the outpatient system to reduce the risk of "over-treatment" and an overreliance on hospital-based consultants to diagnose and advise on treatment.
A Welsh government spokesperson said: "We welcome the Wales Audit Office's report, which recognises the good practice underway across Wales, the prudent healthcare agenda and our planned care programme, which will set and deliver good practice across the country."