Hospital Physiotherapy Outpatient Department Waiting Lists

Abstract

Summary Background and purpose Although there has been some limited publicity about physiotherapy outpatient waiting lists the extent and management of these are unknown. This exploratory survey was conducted to provide information on the extent, management and perceived reasons for outpatient waiting lists. Methods A convenience sample of 54 physiotherapy outpatient managers (mainly in the London and Eastern region) were sent a postal questionnaire in November 1999. Forty-five responses (83%) were suitable for analysis. Findings Thirty-eight departments (84%) felt they had a problem meeting their level of referrals. Of these the longest wait in the past year was on average 22 weeks (sd 9.1). All but one department prioritised their waiting lists. Target waiting times were compared with actual waiting times for the different priorities of conditions. It showed that ‘acute/urgent' patients were being seen sooner than target, while ‘sub-acute' patients were seen on target. The waiting time was shifted to the ‘chronic/routine' patients who were waiting on average an additional five to six weeks longer than the target time average of nine weeks. The problems with waiting lists were ascribed to a continuing increase in referral level, thought by some to be due to an increased awareness of the benefits of physiotherapy, and insufficient staffing levels. Many waiting list initiatives had been tried in an attempt to address the problem and these are described. The methods most frequently used and judged to be most effective involved changes to appointment systems and policies to reduce non-attendance. Conclusion Although the findings of this study cannot be generalised to the rest of the NHS, it raises several issues about the management of waiting lists. While it is unlikely that staffing shortages will be resolved in the short term there is a need to look at the equity of the present system which appears to disadvantage ‘chronic' patients. Different methods of patient management such as advice/triage/group work appear to hold some promise but more research needs to be carried out.