WAITING LIST MANAGEMENT IN GENERAL-PRACTICE - A REVIEW OF ORTHOPEDIC PATIENTS

Objective-To review all patients on a current general practice orthopa edic waiting list for outpatient appointments with regard to accuracy of the list, clinical priority, and need for further radiological inve stigation before hospital attendance. Design-Record review by one gene ral practitioner and a radiologist, and discussion with patients of ma nagement alternatives. Setting-Six partner city centre urban fund-hold ing general practice, list size 8651 (29% low deprivation payment stat us). Subjects-116 adults on an orthopaedic waiting list. Main outcome measures-List accuracy (patient details and status on waiting list); c linical priority (severity of condition); further investigations (resu lts of tests after radiological review). Results-32 patients (28%) wer e removed from the waiting list because of inaccuracies. 14 patients w ere considered to be high priority and referred to other hospitals by utilising waiting list initiative funds. Of these patients, five agree d to referral to another hospital (treatment completed on average with in three months of rereferral), six did not wish to be rereferred, and two did not attend to discuss the offer and remained on the original waiting list. One prioritised patient had further radiological investi gations, was reassured, and was taken off the waiting List. 10 patient s had further investigations. These resulted in six patients being ref erred to other hospitals, three being taken off the waiting list, and one seeking private care. Conclusions-Systematic review of patients on an orthopaedic waiting list of one general practice, though time cons uming, led to the identification of inaccuracies in the list and chang es in management. Costs need further evaluation, but if the findings o ccur widely substantial benefits could be achieved for patients.