patient
choice.
does that involve travelling long distances to hospitals to be
seen
sooner?
Patient Choice audit
Summary
There’s an NHS waiting list crisis. It’s a key priority for the Government, so it recently launched Patient Choice. Patients can choose a referral from their GP to any hospital in the country – based on waiting time, distance and quality.
What
We did an audit of the referral of system with two patients, to ENT and Rheumatology, to see what was actually available, and analysed the waiting time and distance to travel.
Results
The results showed that patients did not generally have to travel longer distances to be seen sooner. There were similar patterns of appointment availabilities at longer distances.
Patient Choice
There are long waiting lists for hospital treatment at the moment, but truthfully we were struggling even before the pandemic. The government has launched Patient choice. This is designed to even out demand whilst increasing supply, with more private providers. The NHS will pay private providers at the same rate as it would pay NHS hospitals: there is no cost to patients.
The choice of hospitals has been around since 2004, but the new system allows patients more control of the process.
Sounds pretty good. The assumption was if we travelled further, we’d get seen sooner. We decided to test this out with a few referrals.
What we found
We looked at 2 patients that needed GP referrals, one for ENT (Ear Nose and Throat) and the other for rheumatology.
We made a list of choices that were available for each speciality and grouped them into distances from where patients lived. There were 4 groups; under 15 miles, 16-30 miles, 31-45 miles and over 45 miles.
We listed the wait times for treatment for each of these groups. Under 18 weeks was green, 19-29 weeks was amber and over 30 weeks was red.
The results were surprising.
Ear Nose & Throat referrals
Rheumatology referrals
Conclusion
The theory that if patients were to travel across the country, they would be seen sooner, doesn’t appear to stack up, according to our initial findings. There appear to be similar waits for hospitals within 15 miles and those over 45 miles away. This is promising, as it allows patients to have investigations and follow ups at the hospital that is not too far away. It seems perhaps that the distribution of demand and the increased capacity is resulting in people not having to wait too long at hospitals near their homes.
One of the challenges is that the initial referral in general practice is quite time consuming. However, this is offset by a reduction in admin time in chasing up, amending or cancelling referrals, as patients can do this for themselves. One of the other challenges, however, is that different hospitals have different referral criteria such as fertility.
Our next step is to identify specialities which have similar referral criteria for common conditions and support patients to choose.
Some of the things we have done….
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NHS waiting list audit
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Inter-professional education and training
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How to do an NHS patient survey
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Behaviour change in primary care
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NHS Innovation labs
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Hiyos Helpers – NHS volunteering
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Patient survey during pandemic
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Where should we move to?