Turning ‘waiting lists’ for elective surgery into ‘preparation lists’

Turning ‘waiting lists’ for elective surgery into ‘preparation lists

Levy N et al. Turning ‘waiting lists’ for elective surgery into ‘preparation lists’. BJA. 2020. DOI: 10.1016/j.bja.2020.08.021

What is already known:

Waiting lists for elective surgical procedures are a feature of centrally-funded healthcare systems. The global population is ageing and there is increasing associated comorbidity producing an increasing requirement for healthcare and surgical procedures. Overall the number of patients on waiting lists is set to continue growing. Large surgical waiting lists can have wide-ranging negative effects including the impact on the individuals’ physical and mental health, the impact on society – healthcare, economic, social and political and the increased pressure on health and social care workers. The preoperative phase represents a valuable window of opportunity to optimise chronic comorbidities, improve physical health and psychologically prepare an individual for surgery. This approach has been shown to improve patient outcomes and satisfaction following surgery and is a key tenet of ERAS pathways.

What this paper adds:

This interesting and thought-provoking editorial highlights the potential benefits of making a conceptual change as to how we as a society approach elective surgical waiting lists. The authors explain in a logical and systematic fashion the rationale for moving from a passive situation where ‘waiting lists’ are viewed negatively as time spent in stasis with a debilitating health condition to a proactive approach where ‘preparation lists’ are viewed as an opportunity to address comorbidities, improve physical health and psychologically prepare patients for their surgery. The potential benefits of making this change are enormous, encompassing positive impacts on patient outcomes and experience as well as on society as a whole.

Dr Leigh Kelliher, Royal Surrey County Hospital NHS Foundation Trust, UK.