(Un)timely care: findings from the Waiting Times project.

Abstract

There is a historic crisis in waiting times in the UK's National Health Service. Crisis brings both a call for judgement - a response to the question 'what has gone wrong?' - and a call to action, such as better management, more resources, strategies to mitigate staff burnout, or even a shift in access commitments to reduce demand. However, not all forms of waiting are a sign of service inefficiency or failure, or a form of abandonment or lack of care. Instead, we argue that all healthcare entails waiting, and other forms of elongated time such as pausing to observe, staying alongside patients at end of life, enduring or even encouraging the repeated presentations of those with medically unexplained symptoms, delaying treatment to see what time will bring the situation, or stopping treatment as an ethical intervention. In this paper, we offer three examples of care practices that require waiting, demanding considerable patience on the part of patients and healthcare workers: care for the chronically unwell in general practice; care of young people in mental health crisis; and care for trans and gender-questioning young people. When time is represented as a finite linear resource to be used efficiently, 'streamlining', speeding up systems, and making cuts to 'wasteful' practices seem like obvious solutions. But we argue that it is only by reckoning with the complex relationality and fundamental untimeliness of the care that runs alongside even the most timely interventions, that we can understand what it means to wait in and for the NHS, and what resources might be needed for the service and its users to flourish.