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  The impact of extended waiting times for treatment and investigation in people Long-term conditions


   Research School

   Applications accepted all year round  Self-Funded PhD Students Only

About the Project

Waiting lists for hospital treatment have steadily increased since 2016 (2016 was the last time that the 18-week treatment target was met by the NHS). Waiting times have risen at a faster pace from 2020/2021 (Pope 2023). The number of people on a waiting list for hospital treatment rose to a record of 7.2 million in January 2023 (NHS England 2023), this figure is likely to continue to increase over the coming years as services manage backlogs, deal with increased demand and address workforce issues.

Multiple studies have investigated the impact of delays in access to care, and historically the delay between referral and treatment has not been a concern (e.g., Koo et al 2020, Stack et al 2019, Stack et al 2012). However, as waiting times increase, the concern about delay during this period is also increasing (Mathew 2022, Salisbury et al 2023). People with long-term conditions are increasingly likely to face delays when referred for further investigation and treatment and it is vital that the impact of waiting time delay is investigated.

Of particular concern is the increased levels of psychological distress, unmanaged pain, increased long-term disability and the need to access additional health services while waiting for treatment (Mathew 2022). This requires further investigation alongside the way that people cope with and manage their long-term condition while waiting for treatment. There are also concerns that there may be inequalities in the experience of waiting times between different communities, for example, some regions offer greater choice about treatment location, and on an individual level social economic factors may make faster private healthcare an option for the management of some aspects of healthcare (Moscelli et al 2023).

Aims

The aim of this PhD is to investigate how people with long-term conditions cope with extended waiting times, and the strategies they use to manage delay while waiting for treatment. The PhD will investigate coping, wellbeing and the impact of extended waiting list delay on other services (NHS, public, charity and private). The PhD student may choose to focus on a sub-set of conditions or referrals in a specialist area.

Methods

  1. Local population data analysis to understand local inequalities in waiting time management. To understand local waiting times, and of public health data for Herefordshire and Worcestershire region in collaboration with the integrated care board. The ISC are keen to identify where inequalities exist, therefore, the analysis will involve a local inequality impact analysis.
  2. Qualitative interviews with people on waiting lists. Interviews will be focused on coping strategies, concerns related to delay (e.g., worsening prognosis, pain etc) and the way other services are access while waiting.
  3. Data from the interviews will be used to construct the content of a questionnaire to be sent to a larger population of people who have been waiting for a year for treatment. The questionnaire is likely to be focused on coping and services accessed while on waiting lists.

Application Process

To begin the application process please go to https://www.worcester.ac.uk/courses/medical-sciences-mphilphd and click on ‘How to Apply’ in the top menu. This PhD could be carried out on a part time or full-time basis so please select the relevant application link. On the application form, please make it clear that you are applying for one of our advertised projects so we can direct it straight to the relevant people.

The Interview

All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Research School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

Funding your PhD

For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/fees-and-finance/doctoral-loans.aspx

During your PhD you can access the Research Student Support Scheme to support dissemination costs associated with your research, up to £500 a year.

Living Well with Long-Term Conditions Research Group

Approximately 15 million people in England, representing 1 in 4 adults, have one or more long-term conditions (LTCs). A LTC is an illness that cannot be cured but may be controlled with medicines or other treatments. People living with LTCs face considerable challenges around the management of their long-term physical and mental health.

The ‘Living Well with Long-Term Conditions’ Research Group aims to facilitate the development and implementation of high-quality research and knowledge exchange, targeted at helping people with long-term conditions and their families to live well.

Widening Participation

As part of its mission statement the University is committed to widening participation for its higher degrees. Although most candidates will have an undergraduate and/or a Masters degree, the University is happy to accept applications from candidates with relevant professional qualifications and work related experience.

Supervisory team

Professor Rebecca Stack, Dr Dez Kyte

Director of Studies:

Professor Rebecca Stack, Living Well with Long-Term Conditions Research Group, Three Counties Medical School, University of Worcester

Supervisors:

Dr Dez Kyte Living Well with Long-Term Conditions Research Group, School of Allied Health and Community, University of Worcester

Research Group: Living Well with Lon-Term Conditions Research Group

For further information or an informal discussion on this project, please contact Prof Rebecca Stack (Director of Studies) via email at

Nursing & Health (27) Psychology (31)

References

Koo, M. M., Lyratzopoulos, G., Herbert, A., Abel, G. A., Taylor, R. M., Barber, J. A., ... & Fern, L. A. (2020). Association of self-reported presenting symptoms with timeliness of help-seeking among adolescents and young adults with cancer in the BRIGHTLIGHT study. JAMA Network Open, 3(9), e2015437-e2015437.
Mathew, R. (2022). Rammya Mathew: Long and uncertain waiting times are leading to poorer health outcomes. bmj, 379.
Moscelli, G., Gravelle, H., & Siciliani, L. (2023). The effect of hospital choice and competition on inequalities in waiting times. Journal of Economic Behavior & Organization, 205, 169-201.
NHS England (2023). Consultant led referral to treatment times https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/
Pope, C. (2023). NHS waiting times: a government pledge. bmj, 380.
Salisbury, L., Baraitser, L., Catty, J., Anucha, K., Davies, S., Flexer, M. J., ... & Osserman, J. (2023). A waiting crisis?. The Lancet, 401(10375), 428-429.
Stack, R. J., Shaw, K., Mallen, C., Herron-Marx, S., Horne, R., & Raza, K. (2012). Delays in help seeking at the onset of the symptoms of rheumatoid arthritis: a systematic synthesis of qualitative literature. Annals of the rheumatic diseases, 71(4), 493-497.
Stack, R. J., Nightingale, P., Jinks, C., Shaw, K., Herron-Marx, S., Horne, R., ... & Raza, K. (2019). Delays between the onset of symptoms and first rheumatology consultation in patients with rheumatoid arthritis in the UK: an observational study. BMJ open, 9(3), e024361.

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