Managing the Fife ENT Waiting List: The 1989 Review of Problems

In-patient activity of Fife Ear, Nose and Throat (ENT) wards and of Fife ENT consultants are higher than the Scottish averages. Out-patient activity appears to operate at a lower level and hundreds of patients remain on the Fife waiting list for operations. An analysis of 731 patients on the ENT waiting list in 1989 showed that 15% had been waiting for over three years. Over 350 hours of theatre time and over 3,200 in-patient bed days would be required to clear this waiting list. Adopting a guillotine tonsillectomy operative procedure without anaesthesia would make a major contribution to a rapid reduction of the waiting list. Although this is reported to be quick, relatively painless and remarkably free from haemorrhagic complications, it appears not to be acceptable in our medical culture at the moment. A life table analysis suggests that Fife is failing to operate on patients at a rate compatible with the needs of the community: current trends of operating suggest that over one half of patients will be on the waiting list for operations three years after being placed on it. The Secretary of State's 1989–90 waiting list initiative, the appointment of an extra ENT consultant and the allocation of additional operating theatre time may help to resolve these difficulties.