Urgency and priority models

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7147.1828a (Published 13 June 1998) Cite this as: BMJ 1998;316:1828

Model has limited practical application

  1. Ian M Mitchell, Consultant cardiothoracic surgeon,
  2. David W Quinn, Research fellow
  1. Nottingham City Hospital, Nottingham NG5 1PB
  2. University of Sheffield, Sheffield S10 2RX
  3. Barnsley District General Hospital, Barnsley S75 2EP
  4. Northern General Hospital, Sheffield S5 7AU

    EDITOR The recent interest in priority scoring for surgical operations is to be commended. The paper by the Northern Ireland Clinical Resource Efficiency Support Team highlights the differences between “urgency” and “priority” and how demographic and lifestyle related details may influence the timing of coronary artery bypass surgery.1 Unfortunately this model has limited practical application.

    Firstly, although the opinion of the referring doctor is important, the ultimate responsibility for prioritising the waiting list lies with the cardiac surgeons, who represented only a minority of the judges (4 out of 33). Furthermore, the study does not take into account how cardiac surgeons organise their waiting lists. Some run their list individually and some operate a joint waiting list; most would separate the list into emergency, urgent, and routine cases, but few would adopt a more sophisticated priority system within each group. This is not to say such an approach would be wrong, but it would imply a constant reshuffling of …

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