Long surgical waiting lists: improving outcomes with patient information (a blog by Julie Smith)

Summary

Julie Smith, Topic Leader for the hub and Content Director at EIDO Healthcare, takes a look at how patient information can be used to help improve outcomes for those on long surgical waiting lists.

Content

In a recent meeting a spinal surgeon based in Wales told me that some of his patients are expecting to wait 3 years for their planned operation. Other health professionals have told me their patients are waiting anything between 18 months and 2 years.

Around 3000 people in England had been on a waiting list for more than 2 years as of April 2021, as reported by the Kings Fund [1]. More recently (October 2022), the BMA [2] reported that nearly half a million people in England are waiting over a year for consultant-led elective care. While this may come as a shock to many, for those working in the NHS, this is a grim and familiar reality. Even if you aren’t waiting for surgery, you will be aware of the waits for any level of NHS care, be it an appointment with your GP, a call to 111 or perhaps even a medical emergency.

This clearly presents significant risks to patient safety and innovative approaches are being taken across every part of the NHS to mitigate them as much as possible. An area that is of particular interest to me, of course, is patient information.

Lifestyle changes

Strange as it may sound, while waiting months or even years can increase risks, it also presents an opportunity to improve outcomes. Patients are generally advised to maintain a healthy weight, quit smoking, reduce alcohol intake and exercise regularly in the lead up to their operation. If a patient has a long wait for surgery, they have more time to work on these areas.

Studies have proven time and again that positive lifestyle changes can significantly reduce the risk of infection, cardiovascular and pulmonary problems, anaesthesia-related issues, longer hospital stays and more [3]. Recovery is also likely to be faster and smoother if the patient is healthy. Those responsible for supplying information to patients must take advantage of this time to properly educate them on these benefits. The NHS has some online resources that patients can be directed to.

Knowing what to look out for while on a waiting list

A long wait for an operation can be a worry. It can also exacerbate the problem as symptoms worsen with time. Again, information is key here. There is a risk that patients on waiting lists ignore their symptoms as they feel reassured that they are waiting for an operation to resolve them. However, there will be some red-flag symptoms that indicate the patient is in danger of deteriorating if they are not seen urgently by a health professional. It is essential that patients are fully informed of health-related red flags and what to do about them if they occur. It could mean anything from contacting their GP to calling an ambulance.

Our leaflets, designed to support patients deciding about their care, have recently been updated to better inform those on long waiting lists. The leaflets are procedure-specific and so is the waiting list advice. Patients are advised on which symptoms, specific to their condition, to look out for and what to do if they develop or worsen. Information around lifestyle changes has also been elaborated on.

Whether an EIDO leaflet is available or not, this is a really important consideration for all health professionals managing communication with patients on waiting lists. Equally important is regular check-ins from their healthcare team to reassure them and discuss any concerns. This can be particularly helpful if the patient’s mental health is at risk. If patients are not having these check-ins, I would encourage them to ask for them.

A longer lead time between being added to the waiting list and the date of surgery allows patients longer to get themselves ready. It also makes patients more vulnerable to deterioration. High-quality patient information could make the difference between a good and a bad outcome.

References

1. Waiting times for elective (non-urgent) treatment: referral to treatment (RTT). Kings Fund. 5 August 2-21. Accessed online 14/02/23. 
2. NHS backlog data analysis. BMA. Accessed online 14/02/23. 
3. Preparing for an operation with lifestyle changes. Cochrane UK. Accessed online 14/02/23.

About the Author

Julie is the Content Director at EIDO Healthcare. She oversees a library of leaflets used to support patients in making informed decisions about their care, with a focus on medical procedures and operations. Julie and her team are trained in Plain English, risk communication, easy-read information, translation processes and more.

Julie is a healthcare editor by background and previously worked at MA Healthcare as Editorial Director, overseeing 25 healthcare journals. She was also the Editor for a number of journals while at MA Healthcare, including the British Journal of Nursing and British Journal of Community Nursing. She is a member of the PIF TICK steering group and a Trustee and Board Member of the Lindsay Leg Club Foundation.

Julie is also a Patient Information Topic Leader for the hub.