Written evidence submitted by Patient Experience Library (CBP0004)
1. Inquiry question: What capacity is available within the NHS to deal with the current backlog? To what extent are the required resources in place, including the right number of staff with the right skills mix, to address the backlog?
1.1 Waiting times
Our waiting list tracker (www.patientlibrary.net/waitinglists) shows an inexorable rise in elective care waiting times over the last year.
Media headlines talk of 5 million plus people waiting for treatment, but that is of little interest to people on waiting lists. They do not want national headlines. They want to know the waiting times for the treatments they need at the Trusts near them.
The same is true for GPs who are trying to manage patient expectations while also supporting shared decision-making and informed choice. And it applies to Heads of Elective Care, who are trying to optimise patient flow via co-operation with nearby Trusts, whose waits for some services might be shorter.
All of these - patients, GPs and Heads of Elective Care - need better information than they are getting at present.
1.2 Wasting time
A recent report by National Voices (https://pexlib.net/?226974) describes people on waiting lists "remaining in an information vacuum for long periods of time". Another, from the Policy Exchange (https://pexlib.net/?231558) talks of patients "being left in limbo".
The National Voices report goes on to describe people who, in the absence of clear information, end up "chasing referrals" and making "multiple phone calls". It is likely that GPs are taking the brunt of this. They, in turn, will be chasing specialists and elective care teams. But those people are often no better placed to understand waiting times.
National data (https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2021-22/) is always at least two months out of date, and is published via large Excel workbooks with confusing layouts and incomprehensible abbreviations. It is hard to find and hard to make sense of.
As patients chase professionals, and professionals chase each other, it is likely that a lot of time is being wasted.
2. Inquiry question: How might the organisation and work of the NHS and care services be reformed in order to effectively deal with the backlog, in the short-term, medium-term, and long-term?
One simple but potentially very time saving reform would be to make waiting times data much more accessible.
Doing so will not reduce the backlog - but it might reduce much of the anxiety felt by patients who currently reside in an information vacuum. That could then reduce the pressure on GPs who are having to deal with multiple phone calls from patients seeking information. And that could prevent time being wasted across both primary and secondary care.
Our waiting list tracker (www.patientlibrary.net/waitinglists) shows waiting times for treatments at Trusts right across England. It is available on an open access basis - completely free of charge to both patients and professionals. It is simple to use, requiring no training.
The Policy Exchange report cited above recommends the use of our waiting list tracker by GPs. They are the vital link between patients and secondary care providers.
We could develop the tracker further, to make it even more useful for hard pressed health professionals. For example, it could show waiting list priority codes, or show more detail on treatment types, under the broad headings of cardiology etc.
3. Inquiry question: What can the Department of Health & Social Care, national bodies and local systems do to facilitate innovation as services evolve to meet emerging challenges?
Our waiting list tracker is a simple but very effective innovation. It would be a relatively straightforward matter to improve it still further.
To facilitate further innovation, DHSC and/or the national bodies could help by:
Again, we are not in a position to help reduce the elective care backlog. But we can help to eliminate the information vacuum experienced by both patients and professionals caught up in lengthening waiting times. That, in turn, can help to reduce some of the chasing and poor use of time that those people currently experience.