Hospital consultant raises concerns that the 'sharp elbowed' may be prioritised as waiting lists continue to grow
Concerns were raised by Dr O’Riordan at a joint meeting of the Hertfordshire and west Essex CCGs last week
Hospital consultant Dermot O’Riordan has raised concerns that the ‘sharp elbowed’ and the ‘articulate middle class’ may be prioritised for treatment as waiting lists grow.
And concerns about who may get to the top of those lists fastest were raised by Dr O’Riordan at a joint meeting of the Hertfordshire and west Essex CCGs on Thursday, March 25, during a discussion about waiting lists and harm reviews.
“The second bit which I remain anxious about is that there are gong to be lots of long waiters,” he said.
“And I am really nervous that we will end up prioritising the sharp elbowed and the articulate middle class, who know which buttons to press and who to talk to and how to get the systems working in their favour.
“And there are a lot of other patients who are too polite to bother doctors and the system etc who will not make a fuss who actually may have at least as great clinical need.
“It’s really hard – I don’t have an easy answer.
“But somehow across the board we need to have a system whereby we truly are prioritising on clinical need and not on your ability to know how to work the system in your favour.”
Dr O’Riodan – who is a consultant general surgeon at West Suffolk NHS Foundation Trust – is a member of the East and North Herts CCG governing body.
He made the remarks at the joint meeting, as CCGs quality lead Jane Kinniburgh highlighted the clinical harm review processes.
These are reviews that are usually undertaken wherever patients have waited 52 weeks or more – or there has been a breach of the 62-day cancer standard.
Ms Kinniburgh said that at the West Herts Hospitals Trust patients were reviewed earlier – before their waits reached 48 weeks. And she pointed to this as an example of good practice.
She said that, in common with other areas, there were increasing numbers of patients waiting longer as a result of the pandemic.
And she said the Herts and West Essex ‘integrated care system’ – which brings together the three CCGS – had agreed to adopt a standardised approach to harm reviews.
In response to the presentation Dr O’Riordan also said it was important to maintain a ‘light touch’ approach.
“Clearly the clinical harm reviews for patients who have been waiting a long time are important and have to be done,” he said.
“But they also have to be light touch otherwise clinicians could be spending all of their time doing clinical harm reviews and not actually seeing patients and that side of things.”
Waiting lists for some treatments are known to have increased significantly in recent months, as a result of routine hospital care being ‘paused’ during the pandemic.
Hospital trusts have continued to prioritise the diagnosis and treatment of patients with cancer.
And following the meeting, Dr Jane Halpin, Hertfordshire and West Essex Integrated Care System lead, stressed that care for patients on waiting lists was prioritised according to medical need.
“Our services remain open and we continue to prioritise patients with the most urgent clinical needs and are using extra catch-up clinics and operating sessions in the evening, at weekends and at local independent sector hospitals to do so,” she said.
“If any patient feels their symptoms have changed, or they have new concerns, they should contact their GP practice or the department they are receiving treatment from so our clinicians can ensure they continue to be fully supported.”