Patient Time

It has been quiet up here for the last few weeks. We’ve been occupied by essays and e-learning for the Mary Seacole Programme and the Postgraduate Certificate. It has been really productive and promises to generate some exciting posts over the coming weeks. But time has been an issue.

Time is an issue in healthcare leadership too. I have been challenged to think about valuing patient time. On a busy ward time pressure always seems to relate to the doctor; how can we get more done within a limited shift?

‘Lean’ influenced approaches to health service organisation have been imported from industry – originally Toyota – and have a healthy respect for the ‘customer’. This means orienting healthcare towards what the patient wants. On the whole this is a good thing, but it would obviously be limited where doing what patients wants means missing out on promoting the health of other patients.

An uncontroversial example is cancer waiting lists. Streamlining care to take place within One-Stop Breast Cancer services means that patients get answers quickly. This is important for early treatment, but is also emotionally important as the Hillington Hospitals NHS Trust points out: “Fortunately most women attending the breast unit can be reassured as soon as possible that they don’t have breast cancer.”

Getting patients out of hospital is another way of respecting their time. The Last 1000 Days project puts a premium on patient time from an existential perspective by suggesting that, if you had 1000 days to live, you would want to minimise the number spent in hospital. The economic language comes from Dolan and Holt who launched the project:

“Patient time is the most important currency in health and social care”

Whether it comes from people with frontline experience like Dolan and Holt or hardnosed executives importing factory thinking into the health service, the message is not quite “Time is Money”, but perhaps “Time is more important than Money”.