Despite widespread political and media attention about long waiting lists, a study in this week's British Medical Journal finds that in most instances, substantial numbers of patients waiting longer than six months for elective surgery are restricted to a small number of hospitals.

Researchers at the University of Bristol examined the distribution of patients waiting six months or longer for general surgery; ear, nose, and throat surgery; opthalmic surgery; or trauma and orthopaedic surgery in England.

They found that one quarter of hospital trusts contributed between half and four fifths of the patients waiting six months or longer. They found little evidence to show that measures of capacity (such as beds, operating theatres, doctors) or independent sector activity were associated with prolonged waiting.

This study challenges the widely held assumption that most patients in England are being forced to wait unacceptably long periods of time for elective surgery, say the authors. This experience may be true for a minority of hospitals, but little evidence supports the notion that the waiting list phenomenon in most hospitals in England arises from an overall mismatch between supply and demand.

The long term under-investment in British health care is being tackled, but the waiting list problem cannot be expected to be solved by global investment alone, they conclude.

Full text of paper:

NHS waiting lists and evidence of national or local failure: analysis of health service data