The Impact of Long Waits on Patients and General Practice
Ask anyone working in general practice about the effects of long waiting times for secondary care referrals, and they’ll have plenty to say.
“Patients will come to see me 2, 3 or even 4 times about the same problem,” one GP told me. “Gynae is a classic example. You have a woman of working age with endometriosis. You’ve done all you can, including referral to a gynecologist. But while they wait to be seen, the pain just gets worse, so you prescribe codeine. There’s the pain, the side effects of the opioids, they take time off work, and their mental health deteriorates.”
The consequences of long waits extend beyond individual patients. Families and carers feel the strain when awaiting an autism diagnosis for a child. Older adults experience worsening mobility, increasing the risk of falls while waiting for joint replacements. Even getting a referral accepted is becoming harder due to increasingly complex criteria.
And through it all, general practice is left to pick up the pieces.
“Patients don’t always understand the difference between primary and secondary care, and they think we’re not taking their concerns seriously when we can’t speed things up,” another GP explained. “We’re seen as part of the problem, which strains our relationship with them. Meanwhile, we’re dealing with extra appointments, additional tasks, and the frustration of knowing what we can and cannot do. Over time, this leads to decision fatigue and, ultimately, burnout—because we’re caught in the middle with very little power to change things on their behalf.”
Long wait times aren’t just an inconvenience; they erode trust, create additional workload, and impact both patient outcomes and clinician well-being. So, what can be done to ease the pressure?
NHS Plans to Reduce Elective Care Wait Times
Since the COVID-19 pandemic, elective care waiting lists have surged creating increasing pressure on the NHS. As of November 2024, 6.3 million people in England were waiting for non-urgent appointments, procedures, or operations—equivalent to 1 in 9 people, with an even higher proportion regularly attending GP surgeries.
Reducing these wait times is now a key priority for Integrated Care Systems (ICS), as outlined in the 2025-26 Priorities and Operational Planning Guidance. This aligns with the Reforming Elective Care for Patients plan, which aims to:
- Ensure 65% of patients on waiting lists are seen within 18 weeks of referral by March 2026 (currently around 59%).
- Increase this to 92% by March 2029.
- Provide GPs with £20 per Advice and Guidance consultation to support specialist input and potentially reduce unnecessary referrals.
All of this will take time to work through, and there are no simple answers. It is easy to feel overwhelmed at the scale of the problem, especially when the root causes are frequently not within your control.
Some Practical Steps to Support Patients and Reduce Pressure on General Practice
The law of marginal gains shows that small changes over time can add up to make a big difference to people’s experience and ability to cope and at the same time reduce the burden on general practice staff.
1.ENCOURAGE PATIENTS TO SIGN UP TO THE NHS APP TO MANAGE THEIR REFERRAL
A lot of work has already been carried out in primary care to encourage patients to use the NHS App for repeat prescription ordering, booking or cancelling appointments and checking their patient record.
Over the next two years, at least 70% of elective care appointments will be accessible through the app, with 85% of acute trusts enabling appointment viewing by March 2025.
Encouraging patients to check their referrals via the app can significantly reduce the number of calls to GP surgeries, freeing up administrative and clinical time.
2. ENCOURAGE PATIENTS TO USE DIGITAL SELF MANAGEMENT TOOLS
There are a number of apps available providing self-management advice and exercise programmes. These are particularly helpful for conditions such as MSK, COPD and diabetes and support motivated patients to be proactive in managing their condition while waiting for further follow-up.
Additionally, courses like HOPE (Help Overcoming Problems Effectively) provide a holistic, positive psychology-based approach to managing health challenges and improving well-being.
3. REVIEW FREQUENT ATTENDEES AND OFFER TARGETED SUPPORT
Patients often consult multiple clinicians repeatedly while waiting for specialist input. Running a frequent attender search can help identify those who would benefit from:
- Continuity of care with a dedicated clinician.
- Care coordination, social prescribing, or voluntary sector support.
Patients on waiting lists may not be the most frequent attenders, so reviewing those with 10-30 appointments per year can highlight opportunities to reduce consultation rates, easing demand on your practice.
4. TAKE A SYSTEM APPROACH
The suggestions above play a part in proactively helping people to manage their condition while waiting for treatment and give them some sense of control over what’s happening. Alongside this, the reform plan intends to create efficiencies through using resources differently. Initiatives include group appointments to support people together, or ensuring people can receive an assessment and diagnosis on the same day – cutting out that stressful time of ‘limbo’ between having a test done and receiving the results.
However, this will require a joined-up approach, with hospitals, community services and primary care working together.
For example, a Newcastle pilot programme helped diabetics waiting for surgery to manage their condition more effectively, giving a greater chance of the surgery going ahead. This involved specialist diabetes teams, GP practices, and community services working together.
Identifying similar opportunities in your area can help ensure better patient care while alleviating pressures on general practice.
How Xytal Can Help
We understand the immense pressure primary care teams face and the challenges posed by long waiting times. We work with healthcare teams to develop practical, evidence-based strategies that enhance efficiency, improve patient outcomes, and support clinician well-being.
Our expertise includes:
- Process improvement to reduce inefficiencies and streamline patient pathways.
- Leadership development to equip teams with the skills needed to manage demand effectively.
- Coaching and resilience training to support clinicians in high-pressure environments.
- Change management support to help practices implement system-wide improvements that benefit both patients and staff.
By working together, we can create sustainable solutions that empower general practice teams, improve patient experience, and reduce the impact of long waits on healthcare professionals.
