Maximum waits matter as much as minimum ones

A coded message is being sent to clinical commissioning groups about unacceptable practice. Most GPs would agree with the government’s line, but the Department of Health knows it may be different once they control commissioning budgets.

There are reasons why primary care trusts have been following this policy – with the full knowledge, nodding endorsement and sometimes tacit encouragement of this administration and its predecessor. It is easier to embark on another round of tedious management bashing than to suggest GPs might follow such behaviour.

Part of this unacceptable practice is restriction of competition. Remember this issue was first raised by a private provider complaining of biased commissioning. The message is: look to pluarity of provision to drive the service change which will deliver reduced costs.

An equally significant result of service pressure is revealed in Rob Findlay and Anthony McKeever’s piece about the scandal of long-waiters. Many of the PCT restrictions are for “low value” procedures, but some long-waiters have life-threatening and/or limiting conditions.

Waiting time management measures sometimes conspire to drive patients into this waiting limbo and safeguards such as the NHS constitution have little effect. The government has now pledged itself to act.

This is very good news. For many waiting over a year, it can feel as if they have been forgotten too. The authors offer a practical, low cost solution to targeting the longest waits. We commend it to Richmond House.

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