Published: 24/10/2002, Volume II2, No. 5828 Page 9
A survey into the long waiting lists in ear, nose and throat and audiology services has shown that simply increasing resources will not help reduce waiting times.
The report found huge variation in times, but claimed the discrepancies could not be explained by the level of GP referrals or by shortages of consultants.
The report by the Audit Commission says: 'This does not mean that these factors are irrelevant. It does mean that waiting times alone should not be used to make resource allocation decisions.'
ENT was chosen because it is one of the specialties with the longest waits. The report looked at three groups of patients: children aged 12 and under who had a grommet inserted, adults needing septal surgery, and adults over 60 who were having a hearing aid fitted for the first time.
Researchers looked at evidence from 10 trusts. For grommets, one trust had a median waiting time of only seven weeks for an outpatient consultation and another four weeks for the operation.
By contrast, another trust had a median total wait of 37 weeks.
Septal surgery varied from a total wait of 22 weeks to a total wait of 84 weeks. But as these are median times; some patients will have had to wait far longer.
The wide differences - particularly for grommets - was caused in part by the attitude of consultants. Some strongly felt that grommet operations should be done within a month while at other trusts three months was regarded as acceptable.
There were also administrative problems. Although patients should be seen in order of clinical priority, some are given early slots in the waiting list simply because they phone to complain to the consultant's secretary or because their GP's request for referral is at the top of the pile when an appointment is cancelled.
The report suggests that trusts should use specialist computer programs, available from the Modernisation Agency, to manage the lists more effectively.
Waiting-list policies should be agreed between consultants, GPs and managers. Consultants are also recommended to 'pool' their lists.
The report also showed wide variations in times for patients needing hearing aids.
In one trust the total median time from referral to fitting was eight weeks. In another case it was over a year.
This is partly due to staff shortages and partly due to a lack of money to buy the expensive digital hearing aids preferred by many trusts.