Facts and Opinions: Hospital Wait List Lessons From the UK
Bibliographic record
Abstract
Hospital Wait ListLessons from the UK he issue of reducing waiting for health services in the UK has been a political initiative for the Blair government for several years.Interestingly, "reducing waiting for healthcare" was the key communication in Britain rather than reducing waiting times for "key procedures," which signalled that initiatives were to be put in place to reduce waits in the health system generally.As a result, this included, for example, waits to obtain service from general practitioners, as well as waits for hospital-based services.The wait for healthcare services was, in certain cases, horrendously long, averaging as much as 18 months or more for some in-hospital procedures in some areas of the UK.The public was outraged.Britain has a culture of trial-by-media with a result that there were daily reports on how bad the NHS was compared with other countries in Europe.The barriers to change were substantial; the UK system had not been through the years of reengineering and restructuring that many provinces in Canada have experienced.The result initially was shock, followed by the realization that hospitals did not know how to start to deal with the problems.This led to many false starts and embarrassing media reports.The government initially chose to take a strident shame-orblame approach, using a method that resulted in public exposure on a regular basis.Chief executives in hospitals that didn't conform were removed.Fear was the main motivation for change.The levels of resentment increased, and finally the government took a less aggressive approach.Fear only worked for a short time.Getting compliance internally was easier in the UK than it may be in Canada; many more physicians in the UK are on salary (or some other sessional payment scheme), and so conformance with a hospital-based wait list process was easier to implement in the UK than it may be in Canada.In addition, unlike in Canada, where physicians' secretaries are often the only people who know the extent of the wait, procedure, scheduling and the documentation of wait lists, in the UK, this information was already administered by the hospitals.Another issue facing hospitals in the UK was the extensive (some would say excessive!)governmental reporting requirements.The government initiated a "star" ranking system, which required hospitals to report annually on 140 key performance indicators.Based on the performance of the hospitals on these 140 indicators, the hospitals achieved zero-through three-star ratings.The results were made public.In addition, they were
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.052 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.008 | 0.009 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.014 | 0.021 |
| Insufficient payload (model declined to judge) | 0.017 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".