Professionalism in action: tackling the waiting lists

Insight editor Dr Greg Dollman explores the part doctors can play in tackling long patient waiting lists, and the importance of managing the issue in a compassionate way.

Waiting list“PATIENTS need good doctors.” That’s the first line of paragraph one of the General Medical Council’s Good medical practice. We should use superlatives to describe doctors over the past two years. Not just good, but excellent. But doctors know that their work is never done.

As we look to leave some of the challenges of the pandemic behind, we now face new ones. Waiting lists loom. And still, doctors seek to make the care of their patients their first concern and do their best to make sure all patients receive good care and treatment. This is professionalism in action.

The pandemic has had a significant impact on waiting times for healthcare across the country, and the causes are of course multifactorial. While the government has pledged additional resources to tackle this challenge, it is widely accepted that the backlog will continue for some time yet.

The NHS continues to deliver world-class healthcare to millions of people every day. This is as a result of the professionalism of doctors across the country. The waiting lists would be considerably longer were it not for the determination and goodwill of staff.

The latest figures from NHS England and NHS Improvement show that, at the end of March 2022, more than 62 per cent of patients were waiting up to 18 weeks to start treatment in England. The median waiting time was 12 weeks. Of those waiting, more than 306,000 patients were waiting more than a year and nearly 17,000 patients were waiting more than two years (representing around five per cent and 0.3 per cent of the total waiting, respectively). The pandemic has also had an impact on waiting times in Scotland, Wales and Northern Ireland.

A “human problem”

Sir Robert Francis, Chair of Healthwatch England, commenting on the independent statutory body’s recent research into waiting lists, says that decision makers cannot treat waiting lists as “a mathematical problem”.

“This is not about just getting the total numbers of waiters down as quickly as possible or reducing overall waiting times,” he says. “This is a human problem and we need to focus on managing waiting lists in a compassionate way.”

The application of this message is as relevant for GPs as it is for patients.

While GPs on the frontline may not necessarily be directly involved in the planning of systems and processes to tackle the waiting lists, they can still play an immeasurable part in ensuring that the journey back to the excellent standards we have held before is as professional and compassionate as possible for all involved.

Your professional obligations

GPs have contacted MDDUS seeking advice about how best to approach patient care where there will be delays in the provision of that care. It is always helpful to bear the GMC’s guidance in mind.

  • Make the care of your patients your first concern. This is the starting point of Good medical practice.
  • Give priority to patients according to clinical need if these decisions are within your power.
  • Take prompt action if patients may be at risk because of inadequate premises, equipment or other resources. The GMC provides guidance on how to raise and act on concerns about patient safety.
  • Work in partnership with patients. Patients understandably want to feel in control of their care. When waiting times impact on this, it is more important than ever that patients are confident that shared decision-making is observed and promoted.
  • Communicate effectively. This involves good communication with patients and between colleagues.

Good communication with patients

Both before1 and during the pandemic, health departments have acknowledged the importance of ensuring good communication with patients who are waiting for care. You are well placed to provide patients with personalised and patient-centred communications. You should also direct patients appropriately to others (individuals or departments) who are better placed to answer any concerns they may have about the delays they are experiencing.

Good communication with colleagues

Improvements in waiting times can also be delivered through an effective partnership between primary and secondary care. There are well-established processes and principles in place to strengthen effective and appropriate ways of working together. Handover within primary care and with secondary care colleagues remains an essential part of everyday practice.

  • Provide a good standard of practice and care. Although there may be significant demands on your time, treat the patient in front of you. Do not rush because of concerns about targets.
  • Take part in systems of quality assurance and quality improvement to promote patient safety. Have you identified ways of working more efficiently as an individual or a team? Can you change the ways in which you triage, assess or manage patients? Are there ways of ensuring that the provision of care is inclusive and equitable?

Look after your wellbeing

GPs can only provide good and safe care to patients when they are well. MDDUS recognises the increasing demands our members have faced in recent times, as well as the challenges that lie ahead in tackling the waiting lists. There is much help available, and we encourage GPs to seek the support they need.

MDDUS is proud to offer a free and confidential support service, YourHalo, available to our members 24/7.

In recent times, we have seen how GPs have faced new and daunting challenges with immense professionalism. When the challenges seem insurmountable, take one step at a time. Make your own wellbeing your first concern. You can then, step by step, support your patients through your professionalism in action.

References

1Managing Waiting Times: A Good Practice Guide

Seven Ways to No Delays

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