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- W2000237430 abstract "Part 1 (Waiting in the NHS: a diagnosis) highlighted the deficiencies of waiting-time targets as the principal means of managing lists and concluded that a more comprehensive approach is required1. Waiting-time targets introduce perverse incentives and are isolated from issues of health sector efficiency and opportunity cost. Furthermore, priority on waiting lists is determined not explicitly but implicitly, by clinical judgments. These vary between doctors and between regions and do not relate strongly to patient-experienced health status1. Consequently, we have a poor understanding of the health status of patients on waiting lists, and variation in general practitioner (GP) referral practices leads to differences in apparent need. Simple target-setting is therefore also divorced from NHS equity goals. In this paper we suggest a way forward. We describe moves towards explicit prioritization of patients in other countries, particularly New Zealand. These experiences suggest new directions for the NHS—and pitfalls to avoid.Box 1 summarizes the benefits and drawbacks of explicit prioritization in principle. The NHS is not pursuing improved waiting-list management in isolation2,3: explicit criteria for prioritizing access to surgery have been or are being implemented to varying degrees in several countries, including the UK4,5,6,7,8,9. However, to date, there has been little opportunity to evaluate the successes and failures of these systems in practice10. Experience in New Zealand provides an opportunity to explore the outcomes of explicit prioritization." @default.
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- W2000237430 date "2002-06-01" @default.
- W2000237430 modified "2023-09-23" @default.
- W2000237430 title "Waiting in the NHS, Part 2: a change of prescription" @default.
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- W2000237430 doi "https://doi.org/10.1258/jrsm.95.6.280" @default.
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