Waiting lists for elective (planned) care now stand at more than 7 million open patient pathways--the highest level since the 18-week referral-to-treatment measure was introduced in 2004. The NHS is routinely missing national targets for how long patients should wait. In the face of these record high waiting times for elective care, The King’s Fund undertook research to understand the strategies that have been used to reduce waiting times in England and elsewhere in the past 20 years. Based on a literature review and interviews with those involved in previous efforts to reduce waiting times, the authors found that there is no silver bullet to tackle waiting times. Successful efforts instead need to comprise a mix of activities that focus on managing demand, increasing supply, and creating the right conditions to reduce waiting times and sustain that reduction. Drawing on the experience of reducing waiting times in England in the 2000s, the report highlights that how activities are implemented is just as important as what the activities are. For the experts we interviewed, the achievement of the 18 weeks target was made possible as a result of: valuing and investing in people working in the NHS; a clear, central vision and goal for waiting and an ambition that those working within health care felt equipped to take on; cultivating relationships and leadership at all levels of the health care system; accountability, incentives and targeted support to encourage performance against waiting times targets and other measures of quality of care; and seizing the momentum of wider NHS reform. The report concludes by asking policy-makers and health care leaders to consider key questions about managing demand, increasing supply and creating the right conditions to reduce waiting times.
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