The elective care backlog: short- and long-term measures to reduce waiting times and improve the experience of patients
The elective care backlog is likely to take years to clear and, with the number of patients waiting for diagnostics and treatment set to increase, waiting times will get worse before they get better. In this context, the All-Party Parliamentary Health Group roundtable on 20th October discussed short- and long-term measures to increase capacity and more effectively use available resource to reduce waiting times and improve the experience of patients waiting for treatment.
The discussion made clear that a multipronged approach will be required to reduce the size and scale of the backlog and the amount of time patients spend on waiting lists. The most important factors in achieving this were identified as using waiting lists to improve health, use of digital tools, increased pathway efficiencies, service integration and workforce investment.
Underpinning the response is the pressing need to address inequalities in access, experience and health outcomes. Each of the themes discussed as part of the roundtable must be coproduced and developed with patients, clinicians and the public to ensure success. The measures outlined during the roundtable event all aim to prevent inequality becoming embedded in elective wait times, COVID-19 recovery and the wider health service moving forwards.
The roundtable suggested numerous measures, including:
- Proactively treat patients while they wait, using the waiting list as a period in which action is taken to improve patient’s health prior to treatment, through interventions such as encouraging exercise or supporting patients to give up smoking.
- Digital tools in health services, integrating and continuing the innovation that has recently allowed for online appointments, virtual wards and mass access to the NHS app. Coproduction should guide the development and implementation of these tools.
- Streamlining the patient pathway for the benefit of both patient and services, for example making further use of community pharmacies and improving efficiency in diagnostics, through the use of diagnostic hubs among other tools.
- Integration of diagnostics inputs to streamline patient treatment. For instance, allowing radiographers or other qualified staff members to arrange follow-up this would eliminate the need for results of diagnostic tests to be sent to the referring physician and reduce the time to diagnosis. Another example is that embedding pharmacy records into the health system could remove siloes and allow pharmacists to work more effectively for patients.
- Workforce planning and training for the long term, based on the current and future needs of the population, with staff receiving training across their career to ensure they are working at the top of their profession and increasing workforce wellbeing, retention and efficiency. This requires a long-term workforce plan and strategy to create sustainable change, not a sticking plaster.