Baraitser Lisa, Anucha Kelechi, Catty Jocelyn, Davies Stephanie, Osserman Jordan, Salisbury Laura, Flexer Michael J, Moore Martin D
School of Social Sciences, Birkbeck University of London, London, England, UK.
School of Humanities and Social Sciences, Leeds Beckett University, Leeds, England, UK.
Wellcome Open Res. 2025 Jul 25;9:490. doi: 10.12688/wellcomeopenres.22556.2. eCollection 2024.
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, 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. When time is represented as a finite linear resource to be used efficiently, 'streamlining', speeding up systems, and making cuts to 'wasteful' practices seem like obvious solutions. But we argue that it is only by reckoning with the complex relationality and fundamental untimeliness of the care that runs alongside even the most timely interventions, that we can understand what it means to wait in and for the NHS, and what resources might be needed for the service and its users to flourish.
英国国民医疗服务体系（NHS）的候诊时间正面临一场历史性危机。危机既引发了对判断的呼吁——回应“哪里出了问题？”这一问题——也引发了行动呼吁，比如改善管理、增加资源、采取减轻员工倦怠的策略，甚至改变就诊承诺以减少需求。然而，并非所有形式的等待都是服务效率低下或失败的迹象，也不是一种遗弃或缺乏关怀的形式。相反，我们认为所有医疗保健都需要等待，以及其他形式的延长时间，比如停下来观察、在患者生命末期陪伴、忍受甚至鼓励那些有医学上无法解释症状的患者反复就诊、推迟治疗以观察时间会带来何种情况，或者作为一种伦理干预而停止治疗。在本文中，我们提供了三个需要等待的护理实践例子，这需要患者和医护人员具备极大的耐心：全科医疗中对慢性病患者的护理；对处于心理健康危机中的年轻人的护理；以及对跨性别和性别存疑的年轻人的护理。当时间被视为一种需要高效利用的有限线性资源时，“简化流程”、加快系统运转以及削减“浪费性”做法似乎是显而易见的解决方案。但我们认为，只有通过认识到即使是最及时的干预措施背后护理工作的复杂关联性和根本的不合时宜性，我们才能理解在NHS中等待意味着什么，以及该服务及其用户蓬勃发展可能需要哪些资源。
