Canadian doctors suggest acceptable waiting times for care

Seven Canadian medical organisations have joined forces to develop evidence based benchmarks for acceptable waiting times for certain types of care. Lengthy waiting times are a major concern in Canada.

In April the umbrella organisation the Wait Time Alliance of Canada released an interim report, No More Time to Wait, examining the problem of waiting times for health care in Canada.

The members of the alliance include the Canadian Medical Association, the Canadian Association of Radiologists, the Canadian Association of Nuclear Medicine, the Canadian Association of Radiation Oncologists, the Canadian Cardiovascular Society, the Canadian Ophthalmological Society, and the Canadian Orthopaedic Association.

The alliance is working on a pan-Canadian approach to the issue of waiting times, said its spokeswoman, Ruth Collins-Nakai, president elect of the Canadian Medical Association.

“Much more work is needed to ensure that patients can benefit from improved access and shorter wait times for health services, but we have to start here and now,” said Dr Collins-Nakai. “There really is no more time to wait.”

The alliance has made recommendations for acceptable waiting times for access to care in three categories—emergency (immediate danger to life or limb), urgent or semi-urgent, and routine (a situation involving minimal pain, dysfunction, or disability)—and in five priority areas of care (cancer treatment, cardiac care, joint replacement, sight restoration, and diagnostic imaging). The recommended maximum times that patients should have to wait are based on the best available evidence and clinical consensus. The alliance says that patients' health is likely to be adversely affected if they have to wait longer than these times for access to diagnosis and treatment.

“We're delighted that the specialty groups agreed to come together and create common definitions of what is urgent, emergent, and so forth,” said Dr Collins-Nakai. “Also, it's unprecedented that there is both uniform provincial and federal government and health authority and hospital facility interest in working on this together. What we're hoping is to finalise the benchmark numbers in the next few months and then identify implementation strategies that we can all work on.”

The alliance wants to maintain quality in Canada's healthcare system while ensuring that patients are able to see doctors more quickly and have their procedures done faster, she said.

The Wait Time Alliance proposes these waiting times for care:

• Diagnostic imaging: emergency cases within 24 hours; urgent cases within seven days; semi-urgent cases within 30 days;

• Radiation treatment for cancer patients: routine cases within 10 days;

• Coronary artery bypass graft: emergency cases within 48 hours; urgent and semi-urgent cases within 56 days; routine cases within 180 days;

• Knee and hip replacement surgery: emergency cases within 24 hours; urgent and semi-urgent cases within 90 days; routine cases within nine months (within three months for consultation and within another six months for surgery);

• Cataract surgery: cases requiring routine treatment within four months.

No More Time to Wait: Toward Benchmarks and Best Practices in Wait Time Management is available at www.cma.ca