Impact of a waiting list initiative on a general surgical waiting list

To determine the effects of cuts in surgical beds and operating lists upon the waiting list. To evaluate the effects of the Waiting List Initiative upon the total number of patients on the waiting list, the number of patients waiting for more than one year, and the ratio of patients with low priority, non-life-threatening diagnoses to those with a higher priority, potentially more serious, diagnosis.

The study of facilities available and waiting list figures between 1979-1991; a prospective study of a Waiting List Initiative.

The surgical departments of the Royal Berkshire and Battle Hospitals, Reading and Newbury District Hospital.

Those patients on general surgical waiting lists between 1979 and 1993; those patients who had operations under the Waiting List Initiative.

Between 1979 and 1989 the number of surgical beds fell from 225 to 153, a reduction of 38 per cent. The number of weekly operating lists fell from 40 to 30, a reduction of 25 per cent. The waiting list remained fairly constant, between 1979-1987, with a median of 420 patients (range 295-688) before 1987, against 983 (range 688-1,253) after 1987. After the Waiting List Initiative the total number of patients on the waiting list fell from 1,114 to 904, a fall of 19 per cent. Patients waiting for more than one year fell from 381 to 176 (54 per cent), whilst those waiting less than one year remained constant at 730. The proportion of patients with low priority varicose veins fell from 65 per cent to 40 per cent, whilst the proportion of patients with potentially more serious inguinal hernias rose from 10 per cent to 15 per cent.

These results demonstrate the relationship between the increase in the size of the waiting list and the decrease in the facilities available in beds and operating sessions. While the Waiting List Initiative has resulted in a reduction in the number of patients waiting more than one year, there has been no reduction in numbers waiting less than one year. The reduction has been achieved at the expense of those patients with potentially more serious clinical conditions.