The issue of waiting times is an ongoing problem, but like the length of waiting lists, it shows no sign of abating. A mobile healthcare approach could be one innovative option for providers to consider in the constant battle for improved efficiency, says Ian Gillespie.
During my career in the healthcare sector I was lucky enough to spend time working in the US, where the private sector norm is that patients absolutely expect to be seen within 24 hours - a system where extensive queuing and waiting lists simply don’t exist. Based on my 20 years experience on both sides of the Atlantic, I passionately believe that long waiting times, as seen regularly all over the UK, are a very bad thing and that we really don’t have to accept the status quo.
There seems to be a very British view that exists about waiting times within the NHS, quite simply because the general public apparently “don’t mind queuing” and it seems to me that we are stuck in an unsatisfactory cycle of longer waiting times and increased costs in the system.
Leaving aside the damage to public confidence and patient experience, the level of administration and work needed to pull back a growing waiting list is enormous. It is my opinion that in this country some of us currently have our heads buried far too deep in the sand, and there are many specialists who agree with me that a target waiting list time of 18 weeks is in fact a terrible state of affairs.
Before the economic crisis struck we were witnessing healthcare providers who were committed to reducing waiting times to under 10 weeks, since it was increasingly shown to be more efficient and would help the system and ultimately reduce costs (including bed stays, staff, and impact on services).
It seems we have gone full circle on this, which is a great shame. Patients themselves perceive greater care from the NHS if they are treated in good time, there is less patient suffering, and the overall long term costs are reduced for the NHS.
It is true to say that a significant amount of investment is required in the first instance, which may be difficult to reconcile with such tight budgets. However by taking the “easy option” to let waiting times slip in order to save money in the short term does not take into account the fact that operating at 18 weeks actually costs more money overall.
It is with this in mind that I am flabbergasted more is not being done to make a big push to reduce waiting times to the bare minimum. I would ideally like to see the UK committing to a maximum four to eight week wait for all patients requiring care (there will of course be some exceptions). I am absolutely convinced that the shorter the waiting list, the more efficient the system will be.
Having said all this, it is true to say that NHS executives and clinicians alike have been tasked with some pretty tough decisions in order to create sustainability of their services and efficiencies for their facilities in recent years. This can sometimes, unfortunately, be met by knee-jerk reactions such as ward closures or staff cuts, but all of this is more akin to self harm than self preservation. Unfortunately, decision makers are under immense pressure and often don’t have enough experience of alternative healthcare systems in order to make informed assessments.
I believe that decision makers in today’s health service need to be more than pragmatists. While it’s easy to perhaps accept the inevitable and immediately put in place radical and immediate cost cutting procedures, more and more healthcare decision makers and budget holders are looking to creative solutions which allow them to continue to provide a high level of service. This does not mean just sweating assets which is a reasonable strategy, if you have enough people and resources, but looking outside the box to where short term tactics can support and relieve pressure on waiting lists in particular.
According to findings produced by Arthritis Research UK, patients needing orthopaedic care such as knee and hip replacements, face the longest hospital waits in the NHS. One in six now waits for longer than the 18 week target - the highest of any speciality. A significant minority - about 5 per cent - even wait beyond six months.
Dr Benjamin Ellis, from Arthritis Research UK, has said “More and more NHS hospitals are trying to save money by making people wait for their joint replacement operations. This decline in quality of NHS services is condemning large numbers of people to months of unnecessary pain and disability. Depriving people of timely treatment, many of them older people, is unfair and risks going back to the days when people waited months and years to receive their new joint.”
Bringing healthcare to the people is not a new idea, but bringing temporary operating theatres or wards, without compromising quality of care, is increasingly being seen as a tangible addition to the resources at hand to the NHS and private sector. Temporary or mobile healthcare solutions can provide a spectrum of applications, from the treatment of NHS patients with cataract and orthopaedics surgery, endoscopy and front line oncology screening.
Mobile wards and theatres offer a speedy and practical solution to capacity issues, without the need for immediate additional headcount, by providing temporary and short term solutions to hospitals struggling with long and inefficient waiting times.
One of the greatest challenges for those who share my conviction is to persuade individuals to commit to lowering waiting times for long enough to demonstrate that it does reduce overall costs in the long term. This will require sharing of experience across the NHS and buy-in from politicians and policy makers too.
I believe however that there are examples across other industry sectors that we can learn from. Over the last 20 years they have tried, tested and adopted many new concepts such as flexible manufacturing, sales and operations planning, enterprise wide resource planning and integrated systems, all designed to improve quality and decrease cost. The flexible footprint model is something that architects and building firms are currently talking about adopting within the healthcare system. It’s an approach that would see hospital layouts and processes become flexible enough to accommodate the changing demands of patients.
In this sense, mobile healthcare solutions would certainly be of benefit to NHS providers and play a significant part in helping to bring about greater efficiencies and reduce waiting times across the country – resulting in greater public confidence and a better overall patient experience.