HealthPolicyMonitor | Surveys| LSE - GB| 09| Developments in waiting times

Abstract
Characteristics of this policy
Purpose and process analysis
Expected outcome
References

Abstract

This report is the latest in an ongoing series of reports that detail the progress that has been made towards reducing inpatient waiting times, and will cover the period from September 2006 to January 2007.

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Neue Entwicklungen

As detailed in previous reports, Goverment aspirations are to have a maximum inpatient wait of 18 weeks from referral by a general practitioner (GP) to treatment by the end of 2008. The Government also hopes that many patients will be treated much quicker than this, most in approximately 7 weeks. Government rhetoric suggests that these targets will be met by, for example, offering patients greater choice of provider at the point of referral.

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Suchhilfe

Characteristics of this policy

Innovationsgrad	traditionell	innovativ
Kontroversität	unumstritten	kontrovers
Strukturelle Wirkung	marginal	fundamental
Medienpräsenz	sehr gering	sehr hoch
Übertragbarkeit	sehr systemabhängig	systemneutral
current previous

No particular comment to make that hasn't already been outlined above.

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Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Initiators of idea/main actors

Regierung

Stakeholder positions

The central Government can more or less determine the direction of NHS policy in England and Wales, and successive governments have targetted the reduction of elective waiting times as one of the corner stones of their health policy. As detailed in previous reports, the general public, influenced by the media, use information on waiting times as a strong indicator of how well the NHS is performing.

Actors and positions

Description of actors and their positions

Regierung
Central Government	sehr unterstützend	stark dagegen
Patients and the general public	sehr unterstützend	stark dagegen
Hospitals	sehr unterstützend	stark dagegen
Newspapers, television etc.	sehr unterstützend	stark dagegen
current previous

Influences in policy making and legislation

By being elected in a general election,the Government in the UK has a mandate to implement most NHS policy. It is relatively unusual for the legislative process to block proposed policies in this area. Reductions in waiting times are in any case supported by all of the main political parties, not least because it would probably be politically very damaging to oppose decreased waits.

Legislative outcome

Enactment

Actors and influence

Description of actors and their influence

Regierung
Central Government	sehr groß	kein
Patients and the general public	sehr groß	kein
Hospitals	sehr groß	kein
Newspapers, television etc.	sehr groß	kein
current previous

Positions and Influences at a glance

Graphical actors vs. influence map representing the above actors vs. influences table.

Adoption and implementation

Already discussed

Monitoring and evaluation

The Department of Health monitors progress on waiting lists and waiting times, and issues monthly statistical press releases on developments in this area.

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Expected outcome

The figures on inpatient waits show that 198 English residents were waiting for over 26 weeks for treatment at the end of September 2006. The number waiting for more than 20 weeks was 48,700, and the number waiting for more than 13 weeks was 192,000.

In October 2006, the comparable figures were 353, 49,600, and 188,300. In November 2006, the figures were 212, 44,000 and 165,800. In December 2006, the figures were 138, 46,000 and 181,500. And in January 2007, the figures were 299, 44,600 and 183,300. The number of people on the inpatient waiting list in January 2007 was 774,000, which was one of the lowest since comparable records began in 1988.

Overall, the number of people waiting for more than 13 weeks, 20 weeks and 26 weeks over the four month period (September 2006 to January 2007) appeared to be quite stable. That said, the Government remains confident that it will meet its 18 month waiting target by the end of 2008, and reported in February 2007 that thirteen local health authorities have pledged to achieve this target one year ahead of the rest of the NHS. However, the effect of the demands to reduce waiting times across the whole of the NHS may raise patient expectations to the point of being detrimental to the health care system, not least because expectations have to be met within a fixed budget, and they may therefore distort the priorities of the health care system.