International conference seeks to change the thinking on the relationship between ‘waiting’ and ‘care’

The question of what it is to wait in and for healthcare in modern Britain is the focus of an international conference set to be held in London this month.

At a time when NHS waiting lists dominate the news agenda, delegates from across health and higher education will meet to explore the findings of a five-year study that has looked at the relation between time and care.

Waiting Times, funded by the Wellcome Trust and led by the University of Exeter and Birkbeck, University of London, has brought together researchers from a variety of disciplines, with service users and health professionals. Together, they have collaborated on several workstreams, from unearthing the history of waiting in the NHS, to creating narratives and art inspired and influenced by the experience of waiting.

Around 100 delegates from the UK and other countries as far afield as Australia are expected to attend the event, which will be held online and at Friends House in London, on the 28th and 29th March. The organisers hope that by bringing together researchers and practitioners, some of the findings will go on to influence best practice in the sector.

Professor Laura Salisbury, Professor of Modern Literature and Medical Humanities in the Wellcome Centre for the Cultures and Environments of Health at the University of Exeter, has been one of the co-leads of the project. She said:

“People perceive waiting as the health system not working, but waiting is a fundamental aspect of care. It is there in the time it takes to access services; through the days, weeks, months or years needed for diagnoses; in the time that treatment takes; and in the elongated timeframes of recovery, relapse, remission and dying.

“Waiting Times set out to understand the difficulties and significance for care in an era where time is experienced at increasingly different and complex tempos. This conference will enable us to stimulate conversation and potentially influence best clinical practice on how we use waiting as an active practice of care, and how we can take care of people who are waiting.”

Launched in 2017 with a £1.2m grant from the Wellcome Trust, Waiting Times has focused upon several different aspects. Among them has been an exploration of ‘watchful waiting’ and how it plays an important but underappreciated role in care, particularly through General Practice. Another piece of work explored cultural and historical perspectives on waiting, with researchers undertaking deep archival work, studying doctors’ letters pages, patients’ complaints, adverts, and clinic posters to understand how waiting has been framed at key points in British history.

“While initially there was some concern that the NHS’s mission to repair the damage to the nation’s health caused by centuries of unequal access to treatment could lead to excessive delays, there was also a feeling that this waiting was more tolerable in the knowledge that you were now a patient of the NHS,” says Dr Martin Moore, a historian and Associate Research Fellow in Medical History at Exeter.

“To wait was therefore something we did as a collective, within a shared social project – something which perhaps finds a modern echo in the solidarity demonstrated by communities during lockdown.”

The research team also engaged with mental healthcare services for children and young people, and with hospices and GP clinics, helping patients and staff create new narratives that reflected upon their experiences of time in relation to their healthcare, illness and wellbeing. This work will be showcased via a new website that will remain live for the next five years as a legacy of the project and will also feature at the conference. There will also be a performance from visual artist Martin O’Brien, a Leverhulme Prize winner, whose work explores his experience of living with cystic fibrosis and of ‘living beyond life expectancy’.

“We are at a difficult juncture for the NHS, where waiting times have become a political football to justify the need for restructure and reform, as though time can simply be made more efficient or cost-effective,” adds Professor Lisa Baraitser, co-lead of the project and a Professor of Psychosocial Theory at Birkbeck.

“The concern is that this is becoming a dangerous distraction from the slower work of care that involves the therapeutic use of time.

“Of course, no one should be forced to wait in situations that are medically dangerous, or when a quick intervention will improve clinical outcomes. But there needs to be greater recognition that waiting is not simply the opposite of care, and that by focusing on the ‘quantity of time’ we are losing sight of the ‘quality of time’ needed to care for many people with long-term conditions.”

Registration for the event is open via Eventbrite – https://www.eventbrite.co.uk/e/the-time-of-care-a-waiting-times-hybrid-conference-tickets-490483909577

For more information on the project, follow the link to the Waiting Times site. https://waitingtimes.exeter.ac.uk/the-time-of-care-a-waiting-times-conference-tuesday-28th-wednesday-29th-march/

For more on this theme of ‘waiting’, see the paper A Waiting Crisis? published in The Lancet, last month.