The latest of NHS England’s ‘Inform and innovate webinars’ is a clash of approaches for reducing waiting times.

It starts with the familiar ‘cohort management’ approach to the current waiting time target – the elimination of 65 week waits. The approach is simple: draw up a list of all the named patients who will breach the target when the deadline falls, and then try to get them seen and treated in time.

Does this approach work? It’s not great.

If the hospital’s problem is the sheer numbers of patients on the waiting list, then this approach doesn’t help at all. If the problem is that patients are being booked out of turn, then it might help with the cohort being targeted, but distract from the booking of every other patient. Moreover, the metrics of this approach are highly misleading (and while we’re at it, the target itself is badly designed) as we explain more fully here.

So let’s move on swiftly to the better approach.

This recognises that restoring the ’18 weeks’ waiting time standard means managing the whole waiting list, not just part of it. It contains sensible phrases like “we will need a smaller waiting list of a more sustainable size”, “pathway redesign”, and “multi-year plans”. It emphasises that most patients are waiting for a diagnosis, and only one in five will need admitting to hospital.

But this change of approach might put your hospital in a quandary. Since the pandemic, NHS England have been drilling the cohort management approach which (as the NHS England slides acknowledge) won’t work for the ’18 weeks’ recovery. Hospitals are going to need a whole different set of tools, with different metrics, and a different approach to demand and capacity planning.

Good news: we never abandoned those tools. We have even been publishing free analyses based on them, every month (and you can look up your trust here). Those analyses can tell you where you are now, but the 18 weeks recovery will require a steady look into the future: both for the years up to ‘18 weeks’ restoration, and for the coming weeks and months up to each interim milestone.

There is still time to implement our demand and capacity planning tool for this year’s planning round, so that next financial year can be a full year of progress towards delivering the 18 weeks standard again. Get in touch, and together we can get you off to the right start.