Plain English Summary

Since the start of the COVID-19 pandemic, the provision of elective surgical procedures (like hip replacements) in NHS hospitals has reduced substantially.  There is a range of reasons for this including hospitals cancelling scheduled treatments to create capacity for COVID-19 patients. With elective surgery levels remaining below pre-pandemic levels, the backlog of patients needing treatment remains high and, as a result, waiting lists have reached historically high levels.

Traditionally, the English NHS has operated a single waiting time target of 18 weeks from referral to surgery for most elective procedures. This approach fails to reflect the fact that the range of elective treatments vary in the impacts they have on patients’ health outcomes and have different costs.  Therefore, a targeted waiting time policy that sets different maximum waiting times for different elective procedures may improve overall health across the population and help the NHS ‘to build back better’. 

Our research aims to examine the relationship between waiting times and patients’ health outcomes in terms of quality-adjusted life-years (QALYs), which reflect the impact of treatments on patients’ mortality risk and their health-related quality of life. Using this evidence, the research will consider alternative prioritisation strategies for tackling waiting lists considering the two objectives of maximising overall health outcomes across the population and reducing inequalities in health outcomes between different groups.