BMA proposes strategy to reformulate waiting listsBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7176.78 (Published 09 January 1999) Cite this as: BMJ 1999;318:78
A fairer and more transparent approach to managing UK hospital waiting lists has been suggested in a report published this week by the BMA.
The report recommends the banding of waiting lists into five categories, ranging from emergencies to the lowest priority. It suggests that patients should be given severity scores when they are put on a waiting list, which would reflect their clinical priority and how quickly they should receive surgery. National guidelines would be drawn up for a wide range of operations, so that comparable patients are given the same priority for surgery in all parts of the country.
Under the current system, individual consultants generally manage and prioritise their own waiting lists largely on the basis of personal experience, interests, and preferences. Dr Peter Hawker, who chairs the BMA's consultants' committee, said: “If patients are going to have to wait due to pressures on the service it might be better if there was a genuinely accepted order of priority so they understand why they are waiting six months for one condition, while someone else gets dealt with after a fortnight.” Dr John Chisholm, chairman of the BMA's GPs' committee, agreed: “At the moment patients have no idea what is going on. They get put into a black hole and every now and then after a wait of months get summoned for treatment.”
Dr Hawker emphasised that the report is a consultation document and that many factors remain undecided, such as the optimal balance between social, clinical, and quality of life issues in defining priorities, and who should participate in decision making-specialists, GPs, ethicists, or general public managers. Dr Chisholm pointed out: “Decisions will need to involve GPs as well as specialists, particularly if you need to make judgments based on the extent to which problems interfere with patients' daily lives, loss of mobility, pain, and distress.”
Waiting List Prioritisation Scoring Systems is available free of charge from BMA House, Tavistock Square, London WC1H 9JR.