Intended for healthcare professionals


Strategy to reformulate waiting lists

BMJ 1999; 318 doi: (Published 19 June 1999) Cite this as: BMJ 1999;318:1698

New Zealand has some suggestions for NHS priority system for elective surgery

  1. Janine Cochrane, Project leader for booking systems (
  1. HealthCare Otago, Private Bag 1921, Dunedin, New Zealand
  2. Health Authority ULSS 2, 32032 Feltre, Italy
  3. Booking Service, Health Authority APSS, 38100 Trento, Italy
  4. Paediatric Hospital “Bambin Gesy,” 00153 Rome, Italy
  5. 47037 Rimini, Italy

    EDITOR—I have some suggestions that the BMA might like to consider when it designs the NHS priority system for elective surgery.1 My four suggestions are: use a scoring system instead of “banding” patients; don't use the words “severity score”—instead use “priority score”; include consumers in the groups for developing the priorities; and set up a booking system when you introduce priority assessment.

    I recommend that patients are scored instead of banded because clinicians will be compelled to use the assessment tool to get a score (the alternative is to determine a category for the patient, based on the current clinical decision making). If you have to ration (determine to which level you can provide publicly funded operations) it is much easier to work with a scoring system as opposed to, for example, 25% of D category.

    We have found that the assessment tool (and score) should reflect ability …

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