The Queue Will See You Now

The Queue Comes Home

Somehow, we’ve done it. We’ve managed to import the one feature everyone hates about hospitals — the waiting list — into general practice. Congratulations, everyone. It’s official: the 8am scramble has evolved. No longer will patients have to refresh the phone app like they’re trying for Glastonbury tickets; now they’ll simply join an official NHS-sanctioned queue.

TPP’s new “Waiting Lists” feature in SystmOne arrives just in time for the October 1 contract mandate, requiring every GP practice in England to offer online access tools. On paper, it’s about “managing demand”. In reality, it’s a triage conveyor belt disguised as progress. A queue by any other name still means you’re waiting for care that used to be accessible the same day.

Policy Alchemy: Turning Access Into Delay

The numbers are the headline-grabbers — nearly 6 million online submissions in July, up from 3.4 million last year. Ministers will point to that and beam about “digital transformation”. What they won’t mention is that this “transformation” looks a lot like the digital rebranding of scarcity.

The idea that primary care — the bit of the NHS designed for first contact, immediacy, and continuity — should now manage demand like a booking office is grotesque. We used to absorb the chaos; now we file it neatly into a queue for someone else to ignore later. It’s not modernisation. It’s managed decline with a web form.

The Psychology of the Queue

There’s something viscerally demoralising about it. A waiting list in secondary care implies urgency prioritised by risk. In primary care, it’s a surrender. It says, we can’t even promise to see you — just that you’ve been logged. That’s not access; it’s admin.

For patients, it shifts the psychological burden. “You’re in the system” sounds reassuring until you realise it’s the same system that’s already left 7.4 million people waiting for hospital treatment. For clinicians, it’s yet another system we’ll be blamed for when the queues grow too long.

This Is Not Innovation

Let’s be honest: we’re no longer designing tools to help clinicians care. We’re designing tools to manage absence — of staff, of capacity, of political will. Waiting lists in general practice are not a “solution” to demand. They’re an admission of failure disguised as an API endpoint.

There’s an irony so dense it could form its own event horizon: the digital NHS finally achieves full interoperability between despair and bureaucracy.

Final thought:

We were promised access; we got an inbox. We were told tech would make things smoother; it’s just made the waiting official. For all the fanfare, the new system doesn’t solve the fundamental problem — there simply aren’t enough of us left to see everyone who needs care.

And no amount of queue management can triage that away.