Elective capacity challenges
Despite recent performance improvements and the implementation of rapid and innovative solutions across the NHS, many NHS Trusts are still grappling with numerous challenges to deliver safe and timely care.
In a recent article looking at elective capacity published by the NHS Confederation this month, it was stated that despite the welcome improvements across urgent and emergency care and cancer services, many patients are still waiting too long for treatment.
Analysing the current status of elective capacity, the NHS Confederation article highlighted that the total waiting list for procedures and appointments remained stable at around 7.54 million in March. Still, the number of people waiting more than a year rose to 309,300 in March, up from 305,050 the previous month. Yet, despite April being the busiest for emergency admissions on record, the backlog of patients waiting more than 62 days at the end of March was 14,916 – down from 19,023 for the week ending 26 March last year.
Responding to the latest NHS performance statistics, Rory Deighton, Director of the NHS Confederation’s Acute Network, said: “This data shows some very welcome improvements across cancer and urgent and emergency care services, as well as a large drop in some of the longest waits for elective care. NHS leaders and their teams deserve credit for their meticulous winter planning and incredibly hard work over the last few months to keep patients safe amid unceasing demand, industrial action and the continuing financial and workforce pressures in social care.” (Read the full article here: Too many patients waiting too long).
“This data shows some very welcome improvements across cancer and urgent and emergency care services, as well as a large drop in some of the longest waits for elective care.”
Elective capacity – taking on the waiting lists
While the latest figures show that the 65-week waits have dropped, the overall waiting list for elective care has remained almost unchanged – and the number of patients waiting more than a year has increased.
The annual survey by Accurx also reveals that 53% of NHS Trust staff express concern about their service’s capacity to reduce elective waiting lists. While addressing workforce shortages and cultivating effective leadership are essential for a flexible healthcare system, the immediate application of technology within Trusts can make a significant difference. The survey suggests that the focus should be on something other than digitising existing processes but on utilising technology to manage increased demand effectively.
More innovation to tackle elective recovery
While uncertainties in capital funding and the continued impact of COVID-19 have had their impact, NHS Trusts are tackling their elective capacity issues across the UK with innovative solutions to drive improvements.
Dedicated surgical hubs, new Community Diagnostic Centres, outpatient clinics in retail units and virtual wards are examples of how the NHS is innovating to beat record waiting lists.
In a recent issue of Fortis magazine (the magazine from Health Spaces), we spoke to NHS teams across the UK to find out how they tackle their elective capacity.
Here are some of the findings:
Professional teams are setting new standards
Getting It Right First Time (GIRFT), a national NHS England initiative is accrediting surgical hubs. Guidelines for accreditation have been drawn up in consultation with the Royal College of Surgeons, and these are having a huge impact on elective capacity.
However, it’s not just surgical hubs set up to tackle long waits. There’s a raft of new innovations popping up all around the country in the form of Community Diagnostic Centres. The Elective Recovery Plan also emphasises delivering scans, tests and checks through CDCs in accessible sites, such as shopping centres and football stadiums. A target of opening 160 of these to perform up to nine million additional tests a year by 2025 was set. Alongside the setting up of Community Diagnostic Centres, we are also seeing Health on the High Street initiatives being taken on across the UK.
There’s a raft of new innovations popping up all around the country.
Virtual wards
NHS Trusts across the UK are using virtual wards to help patients continue treatment at home. Virtual wards began during Covid-19 and were focused on supporting people with lung conditions, respiratory problems, and heart failure and people recovering from COVID-19-related hospitalisation.
More recently, NHS Trusts have been expanding their virtual wards and beginning to collaborate with other organisations and providers, including the NHS, local authorities, and housing and community organisations. Research is showing that some of these initiatives are reducing length of stay and showing high levels of patient satisfaction being recorded.
Digitalising appointments
Trusts are implementing digital patient follow-ups to allow patients to seek specialist support or advice, improving patient experience and staff efficiency. Digitising triaging patients is also rapidly reducing elective capacity waiting lists. Personalising communication with patients through various channels, such as SMS messages or phone calls, is proving to save staff time and improve the patient experience. This approach is exemplified by virtual and accessible clinics such as Health On The High Street projects.
Next steps
Clinical engagement is being identified as a key factor in increasing efficiencies. Multidisciplinary teams (MDT) are being involved together in projects to understand the problem from all angles, and this clinical engagement is being shown to help drive innovations and buy-in to solutions.
Mental health & staff morale
Addressing staff morale, gaps in staffing, excellent spaces for NHS staff to break away from work, and getting the right level of capital funding is also being shown to play a key role in ensuring recovery proceeds at the necessary pace.
Integrating innovations with existing systems
The integration of technologies into existing healthcare systems has also been shown to be a critical step, requiring technological upgrades and a shift in the healthcare workforce’s mindset and skills. Training healthcare professionals to adapt to and leverage these new technologies is as important as the innovations. Moreover, there must be a concerted effort to address regulatory and ethical considerations, ensuring that adopting these technologies aligns with patient safety and privacy laws.
Implementing these principles is not only feasible but also crucial for the efficient recovery of the NHS. Simple technologies are already available and, when integrated, can enhance productivity, ensure continuity of care, facilitate better communication between healthcare professionals, contributing to improved patient care, shorter waiting times, and reduced strain on NHS staff and services as the recovery process continues.
The role of the private healthcare sector in alleviating NHS pressures
In August 2023, the newly appointed Elective Recovery Taskforce announced steps to help tackle the waiting lists, including increasing the number of scans, tests and checks by 742,000 annually, achieving this by making eight of 13 new CDCs the responsibility of the independent sector. The task force has a long-term plan that aims to give patients more choices and works to improve how the independent sector and the NHS can work together.
The future of elective surgeries
The landscape of elective surgeries is poised for significant transformation in the coming years, shaped by innovations from within the NHS, as well as technological advancements, demographic shifts, and evolving patient needs. This evolution is expected to usher in a new era of healthcare that is more personalised, technologically sophisticated, and centred around patient and staff experience.
To read the full article NHS Innovation Takes on the Waiting Lists, view our September 2023 edition of Fortis magazine.
About Health Spaces:
As healthcare estate and design consultants, we work with NHS teams to understand their individual clinical needs and estate pressures. Through detailed analysis including workflows such as demand and capacity modelling, and analysis of healthcare economics and population growth, we can support NHS Trusts with rapid solutions to improve elective capacity and tackle waiting lists – from site-wide estate planning and NHS funding guidance, to modular theatres and new hospital wards.
