Elective surgery recovery
Getting elective surgery back on track
The National Performance Advisory Group (NPAG) recently hosted the Theatres and Decontamination Conference at the Coventry Building Society Arena, tackling key issues and challenges within the acute sector – from elective recovery and safe surgery to efficient theatre flow. Louise Frampton reports.
Tackling the elective surgery backlog was high on the agenda at NPAG’s recent conference – NHS data indicates that over seven million people are on waiting lists for specialist clinical care or surgery. Collaboration, dashboards, default to day surgery, Getting it Right First Time (GIRFT) and surgical hubs were among the solutions highlighted that could have an impact on driving down the longest waits. Mark Rigby, head of theatre services at
Warrington and Halton Hospitals NHS Foundation Trust, opened with an insight into the Trust’s efforts to get elective surgery back on track, following the pandemic. The first step was to establish a leadership team to implement a strategy for recovery. There has been significant investment in equipment (including robot-assisted surgery) at the Trust; twenty-two theatres are now operational and new theatres are being built using Targeted Investment Funding (TIF) to help meet demand, he reported.
Mark explained that the NHS England
mandate was to: l Clear long waiters by the end of March 2023. l Tackle the 78-week wait patient cohort. l All patients without a decision to treat to have an appointment booked.
l All patients with a decision to treat to have a 1st definitive treatment.
Trusts have been faced with a significant challenge, to which the Warrington and Halton Hospitals NHS Foundation Trust has responded with a ‘dashboard’ of all the patients, along with weekly touch point meetings. During these meetings, the staffing of theatres is discussed. There have been challenges along the way, but the waiting list of longest waiters has now been significantly reduced. The Trust’s response was to validate patients
on the waiting list, which included: l Patients asking to be removed from the waiting list or having had surgery
l Patients choosing to defer surgery (e.g. watchful waits).
l Patient access plans were cross-checked. with the referral to treatment team.
A long waiters dashboard was also created which displayed: l Patient level detail by specialty. l Incomplete pathways for outpatients and ‘To Come In’ (TCI).
l Stopped clocks. l Run rate required to stay on target.
Structured long waiter touchpoint meetings were held, which focused on tracking progress and escalating delays/barriers. It was important to ensure the stock, equipment and resources were available to meet demand, to avoid unnecessary delays. Mark went on to share an example of the long waiters dashboard. This allowed the teams to monitor progress and
to obtain a clear picture of the task ahead. He explained that the Trust started with 584 patients and reduced this to just 58. He pointed out that some of the patients remaining on the long waiters list were due to reasons beyond the control of the Trust team, such as repeated refusal of surgery by the patient. The challenges to reducing long waiting patients included: l Emergency Care pressures/potential Operational Pressures Escalation Level (OPEL) 4 escalation.
l Availability of elective beds on the acute site. l Industrial action – outpatient and inpatient activity rescheduled.
l Staffing for planned and additional lists – consultants, theatre teams, support teams
l Prioritising CFT/P2 patients. l Patients being fit for surgery – deteriorating health due to extended length of time on waiting list.
l Patient availability. July 2023 I
www.clinicalservicesjournal.com 17
t
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
