JRSM > Volume 94, Number 12 > Pp. 613-616

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Is the National Health Service at the edge of chaos?

Marios C Papadopoulos MD FRCS  ^1,4 Michalis Hadjitheodossiou PhD  ² Costas Chrysostomou MBA FIA  ³ Carl Hardwidge FRCS  ¹   B Anthony Bell MD FRCS  ⁴

¹ Department of Neurosurgery, Hurstwood Park Neurological Centre, Hayward's Heath RH16 4EX, UK
² Center for Satellite & Hybrid Communication Networks, University of Maryland, College Park, MD 20742, USA
³ W M Mercer Global Consulting Inc, 10 South Wacker Drive, Suite 1700, Chicago, IL 60606, USA
⁴ Department of Neurosurgery, Atkinson Morley's Hospital, Copse Hill, London SW20 0NE, UK

Correspondence to: M C Papadopoulos, Hurstwood Park Neurological Centre, Hayward's Heath, West Sussex RH16 4EX, UK E-mail: MPapadopoulos{at}compuserve.com

We used chaos and complexity theory to analyse waiting-list data (1998-2001) pertaining to over 20 000 National Health Service (NHS) patients from general surgical, orthopaedic and neurosurgical units across England. Plots of frequency versus quarter-to-quarter change in waiting times revealed a power relation which seems independent of surgical specialty and hospital location. One interpretation of these findings is that, for the period in question, the NHS was a system at the edge of chaos. This hypothesis might explain why waiting times have resisted attempts at shortening.

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