Evaluating quality and equity issues in the management of hospital waiting lists

Waiting lists act as the predominant rationing mechanism for non-urgent health care in the British National Health Service (NHS). Inequalities persist in waiting times between clinical specialities and geographical areas, which are in no way related to the benefits that patients can gain from being treated or the health sacrifices they make as a result of having to wait. This paper describes a unique yet simple waiting list simulation program which combines activity and health gain data in order to facilitate experiments which explore what happens when patients are selected for treatment according to a range of familiar waiting list criteria which reflect management policy options for the NHS.