EMBARGOED UNTIL 00:00HRS 11 JANUARY 2006
Health policy experts question the NHS 18-week waiting list target
An article in this month’s issue of the Journal of the Royal Society of Medicine examines the Government’s commitment to reduce the NHS waiting list time to 18 weeks.
The Government has pledged that by 2008 there will be a maximum wait of 18 weeks following any GP referral of a patient to treatment in hospital if required.
Written by Richard Lewis and John Appleby, the King’s Fund Senior Fellow in Health Policy and Chief Economist, the article argues that the 18-week waiting list target will be achieved, yet questions whether it is in the interest of patients and the system to meet the target in the long run.
“Despite the forgoing pessimism about the impact of choice and payment by results on waiting times, there are grounds to think that the NHS will substantially hit the 18-week target,”they write.
“Perhaps the more fundamental question to ask is should the 18-week target be met? And, in particular, is the cost of achieving it worth the benefits?”
The authors point to research on patient preferences which show while waiting times were an important factor when choosing a hospital, many patients were willing to forego faster access for longer waits at ‘reputable’ hospitals.
The authors maintain that as the NHS progresses towards the 18-week target fundamental questions of access (of which waiting times is but a part) are raised.
“Access and utilisation of healthcare is generally not equitably distributed across population groups or geographically according to need.
“Tackling this aspect of access is undoubtedly difficult, but goes to the heart of the reason for the existence of the NHS,”they write.
The paper also argues that the cost of meeting the 18-week target may be disproportionate to the benefit gained.
“As waiting times reduce, the value patients place upon further reductions starts to diminish,”write Messrs Lewis and Appleby.
“A better strategy may be to set differential targets for diagnosis and treatment so that in the future shorter waits are mandated for urgent compared to elective care. In the meantime, a wider debate about what the ultimate length of waiting time for non-urgent care is ‘reasonable’ would be valuable,”they said.
‘Can the English NHS meet the 18-week waiting list target?’ is published in the January issue (Vol. 99) of the Journal of the Royal Society of Medicine.
JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.