Achieving waiting time targets: at what cost?

Abstract

Staffing and equipment levels in the UK are impacting heavily on waiting times for radiotherapy. This paper presents the results of financial and organisational interventions on the radiotherapy waiting list at the Derbyshire Royal Infirmary. Efficacy of these interventions was assessed using audits before and after their application. The interventions included working extended days and weekends, employment of agency staff and “out-of-hours” machine servicing and maintenance. A Waiting List and Data Quality radiotherapist was appointed to streamline the radiotherapy referral system. A waiting list database application was developed to book patients in the correct order of priority and within target waiting times. The resulting increase in radiotherapy workload was achieved over a 3-month period at an approximate cost of £30,000, albeit with several implications. Staff felt that the pace of work was unsustainable, although sickness rates did not increase. After the interventions were removed, and waiting times increased, staff morale dropped. Extended working hours impacted on the reliability of the machines, causing more unscheduled interruptions than normal. This indicated the need for additional maintenance or servicing sessions.

This paper shows that full compliance with RCR guidelines for waiting times is achievable, given sufficient financial and organisational assistance.