What are the personal, clinical and social impacts of longer waiting times? A multi-methods study

What are the personal, clinical and social impacts of longer waiting times? A multi-methods study

PhD Project

Waiting times for elective surgery remain an important topic for health policy and health services research. The standard national treatment time guarantee in Scotland is 12 weeks. However, NHS Grampian has also developed an Elective Surgery Categorisation System (ESCatS), which provides new maximum waiting times for three different prioritisation categories across all surgical specialties.

Evaluation so far of ESCatS suggests that people waiting up to a year in lower priority categories seem to experience no substantial difference in their eventual clinical outcomes, or require more emergency admissions. However, we do not know what other impacts longer waits for some people may have. These might be system impacts on the wider NHS, such as increased drug use or extra burden on GPs, or health and social impacts on individuals and families, such as depression, lost days at work/lost income, leisure and social activities foregone, additional demands on family carers. Understanding these potential impacts better would help in designing services.

The University of Aberdeen and NHS Grampian have created a PhD studentship to investigate the impact of waiting times on different groups of people, to support the most clinically effective and least harmful prioritisation. The project will focus particularly on waiting times for hip and knee replacements as a high volume area.

We anticipate a mixed methods PhD, potentially including a systematic review, interviews with patients and family members, PROMS and other survey data, healthcare utilisation data, and linkage to clinical outcomes. There may also be scope for a secondary analysis of existing quantitative data from the C-GALL trial of laparoscopic surgery versus observation/conservative management for gallstone disease to broaden the clinical focus.

This studentship is funded by the University of Aberdeen School of Medicine, Medical Sciences and Nutrition