Waiting list management in general practice: a review of orthopaedic patients.
OBJECTIVE
To review all patients on a current general practice orthopaedic waiting list for outpatient appointments with regard to accuracy of the list, clinical priority, and need for further radiological investigation before hospital attendance.


METHODS
Record review by one general practitioner and a radiologist, and discussion with patients of management alternatives.


METHODS
Six partner city centre urban fund-holding general practice, list size 8651 (29% low deprivation payment status).


METHODS
116 adults on an orthopaedic waiting list.


METHODS
List accuracy (patient details and status on waiting list); clinical priority (severity of condition); further investigations (results of tests after radiological review).


RESULTS
32 patients (28%) were removed from the waiting list because of inaccuracies. 14 patients were considered to be high priority and referred to other hospitals by utilising waiting list initiative funds. Of these patients, five agreed to referral to another hospital (treatment completed on average within 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 investigations, was reassured, and was taken off the waiting list. 10 patients had further investigations. These resulted in six patients being referred 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 consuming, led to the identification of inaccuracies in the list and changes in management. Costs need further evaluation, but if the findings occur widely substantial benefits could be achieved for patients.
Elwyn
G J
GJ
Four Elms Medical Centre, Cardiff.
Williams
L A
LA
Barry
S
S
Kinnersley
P
P
D000328:Adult; D003657:Decision Making; D005194:Family Practice; D006292:Health Priorities; D006301:Health Services Needs and Demand; D006801:Humans; D009985:Orthopedics; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D019037:Urban Health Services; D014850:Waiting Lists; D014852:Wales