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Weighty list! New software may prioritize obese individuals above middle-class patients for NHS elective care.

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By use of a new program, obese people and smokers may be prioritized over middle-class patients on NHS waiting lists.

Dozens of trusts are considering adopting the new “agile waiting list,” which prioritizes patients based on their health and risk factors rather than the length of their wait.

According to its creators, a patient who smokes cigarettes or is obese could be given priority over someone who has waited longer in line.

Weighty list! New software may prioritize obese individuals above middle-class patients for NHS elective care.
Weighty list! New software may prioritize obese individuals above middle-class patients for NHS elective care.

Another example would be a patient from a poor location being prioritized over a patient from a wealthy area with equal needs.

University Hospital Coventry and Warwickshire Trust have built and are actively testing the computer application.

During Covid, trusts have created record backlogs for routine care, and they are attempting to leverage technology to assist them to clear these backlogs.

The medical head of the UHCWT, Professor Kiran Patel, stated that trusts will be free to weigh certain patients based on “social value judgments.”

The software, which is generating attention from approximately 70 trusts, was presented last month during an internal NHS England webinar.

It is already in use in the Coventry and Warwickshire NHS Foundation Trust, which serves over one million patients in the Midlands.

However, opponents have cautioned that social values’ may be subjective and difficult to define.

In England, a record-breaking 6.5 million individuals are currently awaiting standard care.

It is anticipated that this figure will continue to rise for the next two years when patients return to the NHS following delays caused by the pandemic.

Hundreds of thousands of patients have waited for over a year, and hospitals are straining to meet the government’s goal to eliminate two-year delays by the end of this month.

Former Health Secretary Sajid Javid, who resigned on Tuesday, the NHS’s 74th birthday, pledged to digitize the health service last month, arguing that it presently operates like ‘Blockbuster in the age of Netflix.

Professor Patel stated that the present NHS England elective care approach, which prioritizes patients with the longest wait times, “fuels” health disparities.

He suggested that the new agile waiting lists may assist in “level up” healthcare.

Professor Patel explained the software to the Health Service Journal (HSJ) as follows: ‘You can assign different weights to certain parameters. Thus, we have slightly weighted postcodes, for instance.

‘Similarly, if you have patients who smoke, have hypertension, or are overweight, you can use these characteristics to weight the place on the waiting list’

He stated that the algorithm can reschedule the waiting list daily, as opposed to the trust’s existing approach of assigning everyone an 18-week wait.

Professor Patel stated that long waiting periods will continue to beat other considerations, such as weight and affluence.

But if the gap was between 19 and 14 weeks, he proposed that someone from a poorer location who had waited less could be moved up the list.

Under the existing system, wealthier patients wait an average of four weeks less for orthopedic surgery; however, the new algorithm could help level the playing field, he said.

However, a senior official from a different trust, who wished to remain unnamed, cautioned that trusts with their priorities “might be challenged.”

They stated, “Most individuals would accept a wait for a “more needy” individual, but we may all have different definitions of need.”

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