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Waiting list behaviour and the consequences for NHS targets

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  • J Bowers

    (University of Stirling)

Abstract

The United Kingdom's National Health Service (NHS) is investing considerable resources in reducing patient waiting times for elective treatment. This paper describes the development of a waiting list model and its use in a simulation to assess management options. Simulation usually assumes that waiting is adequately described by simple queuing disciplines, typically first-in-first-out. However, waiting in the United Kingdom's NHS is a more complex phenomenon. The waiting list behaviour is explored through an analysis of the changes in waiting time distributions for elective orthopaedics in one Scottish Health Board, NHS Fife. The evolving distributions suggest that there have been substantial changes in priorities in response to the various NHS targets. However, in the short or medium term, the form of the distribution appears reasonably stable, providing a basis for estimating future waiting times in different scenarios. A model of the waiting behaviour and prioritization in the appointment allocations was embedded in a simulation of the complete elective orthopaedic patient journey from referral, through outpatients and diagnostics to surgery. The model has been used to explore the consequences of various management options in the context of the NHS target that no patient should wait more than 18 weeks between referral and treatment.

Suggested Citation

  • J Bowers, 2010. "Waiting list behaviour and the consequences for NHS targets," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(2), pages 246-254, February.
  • Handle: RePEc:pal:jorsoc:v:61:y:2010:i:2:d:10.1057_jors.2008.149
    DOI: 10.1057/jors.2008.149
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    References listed on IDEAS

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    1. J B Jun & S H Jacobson & J R Swisher, 1999. "Application of discrete-event simulation in health care clinics: A survey," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 50(2), pages 109-123, February.
    2. C Vasilakis & B G Sobolev & L Kuramoto & A R Levy, 2007. "A simulation study of scheduling clinic appointments in surgical care: individual surgeon versus pooled lists," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 202-211, February.
    3. Mullen, Penelope M., 2003. "Prioritising waiting lists: how and why?," European Journal of Operational Research, Elsevier, vol. 150(1), pages 32-45, October.
    4. Wall, A.D. & Worthington, D.J., 2007. "Time-dependent analysis of virtual waiting time behaviour in discrete time queues," European Journal of Operational Research, Elsevier, vol. 178(2), pages 482-499, April.
    5. N C Proudlove & S Black & A Fletcher, 2007. "OR and the challenge to improve the NHS: modelling for insight and improvement in in-patient flows," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 145-158, February.
    6. Goddard, John & Tavakoli, Manouche, 2008. "Efficiency and welfare implications of managed public sector hospital waiting lists," European Journal of Operational Research, Elsevier, vol. 184(2), pages 778-792, January.
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    Cited by:

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    2. Fabián Silva-Aravena & Jenny Morales, 2022. "Dynamic Surgical Waiting List Methodology: A Networking Approach," Mathematics, MDPI, vol. 10(13), pages 1-23, July.
    3. Fabián Silva-Aravena & Jimmy H. Gutiérrez-Bahamondes & Hugo Núñez Delafuente & Roberto M. Toledo-Molina, 2022. "An Intelligent System for Patients’ Well-Being: A Multi-Criteria Decision-Making Approach," Mathematics, MDPI, vol. 10(21), pages 1-22, October.
    4. Fabián Silva-Aravena & Hugo Núñez Delafuente & César A. Astudillo, 2022. "A Novel Strategy to Classify Chronic Patients at Risk: A Hybrid Machine Learning Approach," Mathematics, MDPI, vol. 10(17), pages 1-17, August.
    5. Nguyen, Thu Ba T. & Sivakumar, Appa Iyer & Graves, Stephen C., 2018. "Capacity planning with demand uncertainty for outpatient clinics," European Journal of Operational Research, Elsevier, vol. 267(1), pages 338-348.

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