When waiting-time data becomes a patient decision: what a comparison tool can and cannot make safe

Summary

Every month, NHS England publishes waiting-time data for every trust and specialty in the country—hundreds of thousands of rows of it. For years that data has answered questions for planners and journalists while remaining, in practice, invisible to the people waiting. A patient referred for a hip replacement or cataract surgery has had no realistic way of knowing that the hospital 8 miles further away might treat them months sooner. In this blog, Mustafa Ghafouri discusses why he built HospitalWaits—a free tool for patients—and how it can help close the waiting gap. He also highlights the risks and limits of these types of comparison tools and why he welcomes critique from the patient safety community.

Content

HospitalWaits.co.uk is free to use, with no charge to patients or practices. It is run by Doctor Data Ltd and supported by advertising, and its editorial-independence and sponsorship policies are published on the site. Patients enter a specialty and postcode and see every NHS provider in England ranked by published median wait time and distance, with each figure linked to its NHS England source.

The NHS Constitution gives patients in England the legal right to choose their provider at the point of GP referral, and the tool will also draft a letter the patient can take to their GP to ask for that choice—deliberately routing the decision through a clinician rather than around one.

The gap it tries to close

The problem is not that the data is unavailable; it is that patients cannot easily use it. Waiting times for the same operation can vary substantially between trusts within travelling distance of one another, but those differences are often hidden from the people most affected by them: those without private options, patients without confident digital skills, and those who have nobody to interpret the data for them.

The Right to Choose has existed in law for years, but many patients do not know about it and cannot act on it without accessible data, so it may as well not exist.

HospitalWaits is also designed to support the other side of the referral conversation. GPs and practice teams often face the same question from patients—“is anywhere faster?”—and they have seconds, not hours, to respond. The site is built to provide a defensible, source-linked answer at the point of referral: a starting point for shared decision-making, not a substitute for it.

The trade-offs that deserve to be named

Any tool that helps patients act on waiting-time differences changes the system it describes, and it would be dishonest to present that as risk-free.

Demand shift is an unstable equilibrium

If meaningful numbers of patients redirect to the currently fastest providers, those providers slow down. The published data lags this by weeks, so comparison tools like HospitalWaits could, in principle, send patients toward queues that are already lengthening. The counterweight is that choice, exercised at scale, is precisely the mechanism intended to balance load across the system—but nobody should pretend the transition is frictionless.

Choice is not equally accessible

The option to travel further for treatment is not equally available to every patient. Some groups may face practical barriers; for example, older patients who may find longer journeys more difficult, patients on lower incomes for whom the travel cost could be too expensive, and those who depend on hospital transport or carers. A choice tool that is only used by the most mobile or confident will widen inequity rather than reduce it. HospitalWaits can only partly mitigate that risk: it can help patients understand how their local hospital compares, as well as show the options for those who are willing and able to travel.

Distance has clinical consequences

Travelling further for treatment has clinical consequences. An operation done 90 minutes from home means post-operative follow-up, complications and rehabilitation happen 90 minutes from home. This trade-off should be part of the referral conversation—and is one reason the letter HospitalWaits generates is addressed to the GP rather than functioning as a self-service switch.

The data is a snapshot

Published medians describe patients already on the list, not the wait a new referral will experience; they lag by roughly six to eight weeks, and figures from small providers can change quickly on just a handful of cases. Rankings are honest about their source but cannot be more current than the publication cycle that feeds them.

What is built in—and what remains unsolved

Some of these risks have design responses. Every statistic in HospitalWaits links to its source; the methodology, including known limitations, is published in full on the site; small-sample providers are flagged rather than ranked as if their medians were robust; monthly figures are date-stamped so nothing masquerades as live. Emergency care pages never point a patient towards a faster A&E: the nearest-department finder is ordered by distance, never by wait, and the one national table there is published worst-first for accountability rather than as a shortlist. “Which A&E is fastest” is triage advice a data tool must never give. And the Right-to-Choose letter is structured so that the GP—who knows the patient’s clinical picture, mobility and support—remains the decision maker.

However, no design fully protects against demand-shift lag. No free website equalises the ability to travel. Data freshness is bounded by what the NHS publishes. These are limits patients and clinicians should hold in mind while using any comparison tool—this one included.

HospitalWaits allows patients to make an important and consequential decision about waiting times using sourced, dated, caveated information alongside a clinician, rather than making that decision on the basis of a rumour, a single telephone quote, or nothing at all.

Comparison tools like this deserve scrutiny—which is why the methodology is public, and why critique from the patient safety community is actively welcome.

Opinions expressed in blogs and other content are those of the author. Patient Safety Learning welcomes sharing content and opinions that promotes safer patient care and for the reduction of avoidable harm.  The views expressed on the hub however do not necessarily represent Patient Safety Learning's views or values. References to a specific product or service does not imply a recommendation or endorsement.

About the author

Mustafa Ghafouri is a medically trained data scientist and director of Doctor Data Ltd. He built HospitalWaits.co.uk, a free tool that lets patients compare published NHS waiting times by hospital and specialty.