This week, we take a look at how waiting times on the NHS could be shortened through use of the NHS app.
What?
A new government proposal for the NHS app seeks to slash waiting times for operations in the UK, by sending patients across the UK to less busy hospitals. Currently, when being referred for an operation, your GP will choose from a list of local providers. Invariably patients are sent to their local hospital at the discretion of the GP. Patients are currently allowed to suggest they are referred elsewhere, as all patients have the right to choose treatment in any hospital in the UK.
Furthermore, patients have access to My Planned Care, an internet database of all hospital services in the UK, that allows patients to compare waiting times for certain services. For example, the current waiting time for an orthopaedic procedure at the George Eliot Hospital in Nuneaton is approximately 16 weeks. Just up the road however in Coventry, UHCW waiting time for the same procedure is approximately 21 weeks – a difference of over a month!
The new initiative seeks to place this information at the fingertips of patients, within the NHS app. The theory is that with greater access to this information, patient choice will become more streamlined – and in turn spread demand across the UK. This in turn seeks to reduce waiting times for many common elective operations.
Why?
NHS waiting lists have reached catastrophic highs. More than 6.5 million patients are currently waiting to start treatment and this number is increasing. Cutting waiting times for procedures and first appointments is a key target of the government.
The postcode lottery is an NHS phenomenon that describes differences in care across regions. This may be because a higher number of specialist services are concentrated in certain population centres, such as London. This often means patients must travel long distances for these services, as they are not offered more locally, or because more services are available in general.
An interesting example of this is an uncommon disease called pulmonary hypertension (PH). Studies have shown that more people with pulmonary hypertension are found closer to the seven centres in the UK that offer this service (1). Of course this is likely to be the case, and reflects the fact that those living close to these centres are more likely to be diagnosed with PH.
More relevantly, certain hospitals have shorter waiting lists due to a number of factors. The aim is to shift patients from busier centres to less busy centres, to spread demand, and in theory reduce waiting times.
How (does it affect you?)
This is a tricky one.
The data and indeed this service is already available in the form of My Planned Care, a database that contains information on waiting times across the UK. Furthermore patients can already choose to have their care moved to a different NHS hospital, under the terms of the NHS Choice Framework.
This particular innovation seeks to empower the public by putting this information at patients’ fingertips within the NHS app, theoretically improving equal access.
Opponents, such as Paul Nicholl of Doctors Association UK say that this new step will actually create more inequality. He puts forward the notion that those who use the app, will find themselves with an advantage ahead of less tech-savvy patients. Many patients who refer themselves to these services may actually find their referrals rejected, i.e. if they are out of area and their problem does not warrant out of area service. He goes on to say that ultimately, without the staff needed to effect this increase in appointments, we are simply:
“Rearranging the deck chairs on the titanic.”
When given the choice historically, with NHS Choose and Book, many patients referred themselves to the large tertiary (teaching) hospitals; on the assumption that they would receive better care. In actual fact, this creates backlogs in these centres. And the care is not necessarily ‘better’.
An opposing view would be that with information on waiting times more publicly available, the allure of a drastically shorter queue may trump the thin (and often dubious promise) of ‘better care’.
Having greater access to this information is a good thing for patients. Many will see waiting times reduced by hopping services. Ultimately however, in the long run many in the health service (myHSN included), would suggest that the only way to reduce waiting lists is through proper funding of more health professionals to run the services; and separating elective services from emergency services, and a major overhaul of how the health service is run. For more information, take a look at the myHSN op-ed.
In the meantime, here are 8 top tips for shorter waiting times until the data is widely available on the app:
- See your GP early on with a problem to get a referral
- Go with some data, provided by looking at My Planned Care to check waiting lists (for the service you may need)
- Use NHS Choose and Book to choose an appropriate service. Have the referral (and what that leads to) somewhere else in the UK if the waiting times are significantly less
- With all this information, agree on one with your GP
- Check the referral has arrived and appointment given (i.e. you are on the waiting list) and ask for the approximate waiting time. You can do this by ringing either the e-booking service, or a secretary in the department you are being referred to, or both. He/she may help you too if you ask them. E.g. you could ask them to stay in touch re cancelations (see 8). Get to know them
- If it is decided that you need an operation (or procedure) make sure you are on the waiting list for that (and how long you will wait)
- Intermittently check you are still on the waiting list (for the original referral and operation, if needed)
- Regularly call to book into cancellation slots (for both).
As always, best wishes from myHSN!
References:
1. https://www.rcpjournals.org/content/clinmedicine/16/2/135
