How can you cut waiting times? The conventional wisdom is:
- keep the number of patients waiting to a minimum, and
- schedule patients of equal clinical priority in turn.
And the conventional wisdom is correct. But the problem is that the conventional wisdom is also difficult to implement.
Which of your patients have absolutely equal clinical priority? What about all the cancellations and removals that mess up your scheduling? Scheduling is complicated, so unsurprisingly it has been rather neglected over the years. Instead, the focus has been on the number waiting: laying on waiting list initiatives to clear the longest-waiting patients from the list (and then watching in dismay as the long-waits reappear later on).
Yet better scheduling makes a huge difference, and the only cost is managing it. You can see the difference for yourself. Here are some patients who are, shall we say, not being managed terribly well (even though routine patients are mostly being managed with great discipline, and not a minute of capacity is being wasted). The maximum waiting time in this example is 16-18 weeks.
And here are the same patients being managed much better. The maximum waiting time is 11-12 weeks.
If you took the poor example, and just did a waiting list initiative, you would need to reduce the list size by about 25% to get down to 11-12 weeks. That’s only a 20-patient reduction in this case, but then this is only one consultant’s outpatients. Try cutting 25% off the list for all consultants with waiting time pressures, including their inpatients and daycases, and the cost… well, you can estimate it yourself, but it’s going to get rather expensive. Much better to get the scheduling right first.
