‘Hidden wait list’ you should know about if you're planning elective surgery


3 minutes

09 November 2018

Last updated:

Stonemason Michael Harcourt has lived with severe exostosis of the ear for two years, patiently waiting to undergo surgery as his ear canal slowly closes over.

The father of two saw his GP about the condition long ago, and was referred to Perth's Fiona Stanley Hospital so he could be booked in for surgery.

But what caught Harcourt and his family by surprise was the ‘hidden wait list’ he has found himself on as he waits for a first specialist appointment.

The hidden wait list, also referred to by doctors as the ‘wait-to-wait’, is a significant part of the patient journey in the public system that is not accounted for in the 41-day national median waiting time for elective surgery1.

It is the time a patient waits between first presenting to a GP and their first visit with a specialist.

For Harcourt, whose ear canal has almost fully closed over, it has been a two-year wait-to-wait.

“It is quite hard to believe that it takes two years and more to even get to see a specialist and then the real wait begins,” his wife Kristy said.

“I don’t think people really understand that when they hear about waiting lists. What no one tells you is that you have to wait a really long time to even get onto the waiting list.” 

Patient journey diagram

For patients like Harcourt, the ‘hidden wait list’ can be a surprise hurdle on the path to getting healthy again.  

‘Wait-to-wait’ data limitations

Historical reporting of wait times and wait-to-wait data has been fraught with problems. The WA Department of Health has suspended reporting on referrals to public outpatient surgical clinics while work is undertaken to improve the quality, consistency and accuracy of outpatient data, including how it is categorised, collected and reported2. The result of this is that there is currently no accurately reported measure to be able to give you an indication of your likely wait-to-wait time in the public system.

Does wait-to-wait exist in the private system?

The short answer is: yes. But the wait-to-wait in the private system is generally much shorter.

In 2018, Ramsay Health Care and St John of God estimated the average ‘wait-to-wait’ in the private system is two to three weeks, compared to 8.78 months in the public system3.  

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1 AIHW - Elective surgery (2020)?
2 Government of Western Australia Department of Health - Referrals to public outpatient surgical clinics reporting (2018)
3 HBF - Wait Times Report (2018)