Headlines: November 9th, 2000

The health service waiting list culture has been shaken by a project to improve the management of outpatient processes. The eleven hospitals taking part were supported in developing new ways of working and staff were trained in new skills. No additional resources were given to the hospitals. The result was a substantial improvement in performance.The hospitals making up the project group were selected because they had the largest growth in waiting list numbers and they occupied the bottom places in the national league table. Teams from the hospitals spent one day each month with the National Patients Access Team where they planned activities for the month, reported progress and were trained in analysing and modelling patient demand. The project adopted the ‘shock’ approach to unfreeze attitudes and create a confidence that improvement was possible. Following the first meeting of the teams a deadline of three days was set for implementation of the action they had agreed. All but one of the hospitals met the deadline.

The overall improvement in the one year project was a reduction of 20% in numbers of long wait patients. Three of the hospitals moved into the top 25 places in the national league table. There has also been a knock on effect in inpatient waiting lists which have been reduced at a faster rate than those in a control group of hospitals.

A second wave project with 24 hospitals was launched in October 2000.

The message from the project for the NHS 10 year Plan is that increasing resources is important, but to secure a modernised service there must be leadership and a culture change.

Project report: http://www.doh.gov.uk/waitingtimes/trends.pdf