Turning ‘waiting lists’ for elective surgery into ‘preparation lists’

Waiting lists for surgery are an integral part of the UK National Health Service (NHS); they are used as a construct to ration surgery and to reduce costs, whilst simultaneously attempting to distribute limited health resources in an equitable manner. They are a feature of health services that have central funding, financed mainly through general taxation, and are present in several other European countries including Italy, Greece, and Spain, where there is a need to manage the dynamics of capacity and demand. Waiting lists are rarer in countries that rely on private healthcare provision (including insurance) or rely on funding through social security (e.g. USA, Austria, Germany, and France). Nevertheless, independent of the healthcare system, there is an inevitable period of time between diagnosis of an illness that may be amenable to surgery and admission for elective surgery. It is now acknowledged that this time can be better spent in preparing patients for surgery in order to improve the patients' experience of healthcare (including quality outcomes and satisfaction), improve population/public health, and reduce the per capita costs of healthcare.