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Patients to Be Given Offered Choice to Travel for Shorter Waiting Times

Patients are to receive more choice, and are being encouraged to take greater control over their own care, in the latest Government drive to cut hospital waiting times.

At present, only 1 in 10 patients exercise their right to choose where they receive their treatment. However, according to research, giving patients choice can cut "up to 3 months" off their waiting time, a Department of Health and Social Care (DHSC) spokesperson said. 

A report led by the Patients Association, in partnership with the independent sector, in July 2022, found that a patient would need to travel just 13.2 miles to go from one of the worst performing providers to one of the top performers. "Doing so could save patients 14 weeks of waiting if they move from providers with an average waiting time of 22 weeks to one with an average of 8 weeks," the authors said.

However, patients' awareness of choice was "not high, nor are many offered choice regularly", highlighted Rachel Power, the Patients Association's chief executive. Moreover, a Patients Association survey earlier this year found that around only 1 in 6 patients had been given the opportunity to choose where they had their hospital care, she said.

Patients Helped to Make an Appropriate Choice

From now on, "empowering" patients to choose where they receive their NHS care "will help cut waiting lists", announced the Prime Minister, Rishi Sunak.

The NHS App and website would show different provider information – including waiting times, distance to travel, and quality. After speaking with their GP, when clinically appropriate, patients would be able to view this information, for a minimum of five providers, to help them make their choice of where to go for treatment based on their own circumstances.

Patients already on waiting lists would also benefit, reassured the DHSC, as from October those who had waited more than 40 weeks for an appointment, but had not yet been given a treatment date, would be asked whether they wanted to switch hospitals, including to one with a shorter wait, if possible and clinically appropriate.

Power in the Hands of Patients

The NHS App had over 32 million sign ups and received around 75 million visits a month, the DHSC pointed out. It stressed that today's announcement would expand the way that the NHS App and website were used, to improve how patients choose to receive their care. 

Health and Social Care Secretary Steve Barclay emphasised that every patient should be able to "easily choose" where they go to receive treatment and that today’s package would "put that power in their hands".

He hoped that in addition to giving patients more control over their own care, the scheme would "wipe months off their wait" by helping patients to find a hospital or clinic with a shorter waiting list.

Amanda Pritchard, NHS chief executive, said that giving patients greater choice and more information about their care could "change the way people access treatment options". Joe Harrison, chief executive at Milton Keynes University Hospital NHS Foundation Trust, believed the development would help trusts "continue to provide patients with the best possible care, as quickly as possible".

Similar Past Initiatives Achieved 'Mixed Success'

The DHSC said that newly updated software to IT systems would make the process easier for GPs when referring patients for treatment, with NHS England having issued guidance to doctors around the requirement for patients to be offered choice "when clinically appropriate".

Dr Sarah Clark of Westgate Surgery, Otley, commented that patients had different priorities and different needs, and that offering choice "better fulfils" those needs. She hoped it would not only reduce the wait for secondary care referrals, but also reduce the number of appointments not attended by patients who had been given "no option" over where or when they were seen.

Asked to comment for Medscape News UK, Royal College of GPs chair, Professor Kamila Hawthorne, said : "Giving patients more choice about the care they access, and making better use of the technology we have available to facilitate this, is something worth exploring."

She pointed out that the concept of giving patients choice as to where they accessed hospital care was "not new", and that similar initiatives had been tried before, with "mixed success".

Professor Hawthorne counselled that it was important that "lessons are learned" from these to ensure new iterations were "intuitive" for patients, and didn't end up adding to workload in general practice, at a time when "bureaucratic burdens" needed to be cut. 

Whilst welcoming the support general practice would receive, Ms Power emphasised that with the current pressures on general practice, "it will be important they are supported to work in partnership with their patients to increase uptake of patient choice".

Responding to the announcement, NHS Providers welcomed the steps to cut waiting lists, but warned that more NHS staff were needed to deliver care.

"No trust leader wants patients to wait any longer than necessary to get the care they need, so any measures that help the NHS make major inroads into tackling record care backlogs should be given serious consideration," commented director of policy and strategy at NHS Providers, Miriam Deakin.

"We must remember though that improving patient choice is not a panacea for the wider challenges facing the NHS as it tackles record waiting lists," she alerted.

Digital Exclusion Concern

Ms Deakin warned against "digital exclusion", which she stressed could "worsen health inequalities", which had become even more "deep-rooted" since the pandemic.

The DHSC explained that for patients who did not have access to technology, either their GP practice would speak to them and help them select their provider, or they could call the National Referral Helpline, which would talk the patient through their shortlist and support finalising their choice and onward referral.

A "new public awareness campaign" would also encourage patients to exercise their right to choose, and guidance had been provided to GP practices to support them in offering choice, with training available on using IT systems to make referrals, explained the DHSC.

Ms Power hoped the planned communications campaign would "clearly explain" choice and encourage people to exercise it. 

David Hare, chief executive, Independent Healthcare Providers Network, also welcomed the announcement, and felt that an awareness campaign to help the public understand their rights to choose was "good news". 

However, Professor Hawthorne opined that it was essential that any adaptations to the current secondary care booking system were "easy to use", and did not add to the "unsustainable pressure" general practice was facing.

"We also need to be realistic with our patients, given current NHS backlogs, as to what is possible - particularly in terms of waiting times for treatment - so that this new system does not create false expectations," she insisted.