2 December 2002

Patients and surgeons disagree on waiting lists

New research in the December Journal of the Royal Society of Medicine shows up a dramatic difference between consultant surgeons, GPs and patients in their attitudes towards NHS waiting list delays.

In a survey carried out by Mr Graham Kirkby and colleagues at the Birmingham and Midland Eye Centre, only 30% of consultants favoured "pooled" waiting lists compared with 92% of GPs and 82% of patients awaiting routine surgery. The authors warn that consultants "could find themselves isolated" in the current drive for greater efficiency in the Health Service if they oppose changes to waiting list procedures.

Pooled waiting lists for routine surgery
According to government targets, patients should only have to wait a maximum of six months for a cataract operation. In practice, the average waiting time is seven months. One way of reducing this time for routine operations like cataract surgery would be to introduce pooled waiting lists, where a patient is treated by the next available consultant rather than being referred by their GP to a particular surgeon. The authors argue that pooled lists could "maximize theatre use and equalize waiting times for routine cases."

Survey results

• Consultants: 67% of the consultants opposed pooled lists. Some said this was because they feared a loss of control and worried about losing responsibility for care. Many said it devalued the doctor/patient relationship, reducing the surgeon to "a technician on a production line". Others were concerned that pooled lists would encourage lazier colleagues to do less work.
• GPs and patients: Only 8% of GPs opposed pooled lists, the other 92% saying that they were happy for patients to be operated on by the first available, equally experienced surgeon if it meant the operation could be done two or three months sooner. 82% of patients agreed - nearly three-quarters of the patients coming to the follow-up clinic did not know their consultant's name.

The authors point out that for patients and their GPs, the main consideration is "that the operation should be good and done soon". Pooled lists could be one way of increase efficiency, not only for cataract surgery but for other routine operations like hip replacements.

Further new research on NHS delays is published in a separate article in the December JRSM. Read more here.

[ends]

Read the full article [PDF 49k]