Generic waiting lists for routine spinal surgery

Abstract

National Health Service Hospitals are under pressure to reduce waiting lists within the constraints of a limited infrastructure. We implemented two systems to reduce waiting times for elective non-complex spinal surgery. The first of these was the introduction of managed generic waiting lists for both initial outpatient appointments and subsequent surgery. Thereafter, the MRI booking system was integrated with outpatient review appointments. Times from referral to first outpatient appointment and from scan to outpatient review and time on waiting list for surgery were analysed before and after implementation of these changes. Despite constant unit capacity there was a global decrease in waiting times. Before introduction of the generic waiting list, 37% of listed patients waited for more than 9 months; this figure fell to zero. Time from scan to outpatient review was 185 days before integration, 30 days after. Changes of this sort demand a quorum of consultants who will accept each others' recommendations. The generic waiting list will have impact only when there are large disparities in waiting times for different consultants. Targets are met at the expense of continuity of care.

Figure 1

Time patients waited from GP referral to consultant outpatient review: number of patients within three waiting time categories before and after introduction of generic waiting list. ⋄ 0–12 weeks; ▪ 13–26 weeks; ▴ 26+ weeks; • introduction of a generic waiting list for elective spinal surgery

Figure 2

Time patients waited from being placed on a waiting list for surgery until operation: number of patients within three waiting time categories before and after the introduction of generic waiting list. ⋄ Less than 9 months; ▪ 9–18 months; ▴ more than 18 months; • introduction of a generic waiting list for elective spinal surgery