Patients on waiting lists for spinal investigations or surgery can deteriorate quickly, but Noel O'Kelly explores how remote patient monitoring could help to catch early warning signs and reduce preventable harm.
We hear a lot about waiting times. Headlines quote millions of people on the NHS wait list, thousands waiting over a year – and the slow progress of recovery since the pandemic. But what’s missing in those conversations is the harm that happens during the wait.
For spinal patients, this can lead to significant, preventable harm. What begins as pain and tingling can escalate into paralysis, incontinence or permanent nerve damage. For some patients, reduced mobility doesn’t just limit their independence, it also contributes to a decline in confidence and mental health. These aren’t abstract risks - they’re real outcomes happening to patients who are technically ‘on a list’ but effectively invisible.
Waiting lists need to be managed as a clinical exercise but can be mistaken for an administrative one. Once a patient is added, they may only have a couple of check-ins pre-surgery. For high-risk pathways like spinal, this creates a governance gap. Patients deteriorate without oversight and clinicians are left to deal with emergencies that might have been preventable.
From a clinical governance perspective, this is a weak spot. Patient safety standards demand that risks are monitored and managed. Yet on waiting lists, deterioration is often hidden until it tips into crisis. That’s not acceptable for patients and it places avoidable strain on surgeons and the wider health system.
Every specialty suffers from long waits but unlike conditions that remain stable over time, spinal deterioration can be rapid, unpredictable and life changing.
As surgeons know, red-flag symptoms – new numbness, incontinence, mobility loss – require urgent attention. The longer we leave patients unmonitored, the greater the risk that they cross those red lines undetected. The isn’t just about delayed surgery, it’s about the harm caused by the absence of structured clinical oversight.
As clinicians, we want to give patients the best care possible. But with squeezed capacity, stretched resources and rising demand, that isn’t always simple. Finding smarter, more efficient ways to care for patients isn’t just a ‘nice to have’ - it’s essential.
We need to shift our mindset. Waiting lists should not be treated as static queues, they should be considered an active part of the care pathway. That means:
This isn’t about adding more work for surgeons or admin staff. It’s about closing the governance gap and empowering clinicians with smarter systems and technology that can help to provide oversight, escalate risks and keep patients safe until they reach the operating theatre.
If we continue to see waiting lists as administrative backlog, we will continue to see preventable deterioration and emergency admissions. But if we treat waiting as part of care, we can reduce harm, improve surgical outcomes and strengthen trust between patients and clinicians.
The technology to enable this shift exists today. What we need is the drive to treat waiting list management as a patient safety issue, not just a numbers game.
At Clinitouch, we’re looking to work with clinical teams to build safer spinal pathways using remote monitoring. If you’d like to explore how this could work in your service, get in touch for a conversation or demo.
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