(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 and that take place ‘fugitively’, in the ‘seams’ of the NHS, 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. Cutting across the ideological processes of marketisation and provision rationalisation and the linear models of time that have dominated health policy in the past forty years, we argue that understanding ‘timely’ care as relational, interdependent, and paradoxically ‘untimely’ enables a vital recasting of what it means to wait in and for care in the NHS.