By Dr Jo Garland
Infinity Health
The number of people waiting for planned hospital treatment or investigations for a wide range of conditions in England has hit a record high of 5.7m. The list is growing at a rate of approximately 100,000 people per month according to data from NHS England, and the situation varies across specialities and geographical location.
The Health and Social Care Secretary, Sajid Javid, has warned that this is likely to get worse before it gets better, and that the number of people waiting could reach as many as 13m before figures start to fall.
Waiting lists were increasing before the pandemic but Covid-19 has certainly had a major impact. The reasons for this are multifactoral and include diversion of NHS resources to cope with Covid-19 and an increase in the number of people who didn’t or couldn’t access NHS treatment during the pandemic, now being referred to hospital. There are probably many more patients still to come forward.
Regardless of the drivers behind the growing waiting list, the problem must be addressed to ensure NHS patients get the treatment they need within a reasonable timeframe.
Managing elective recovery is a complex process after a serious health crisis with a very tired and reduced workforce.
There are several key challenges to reducing the waiting list for elective treatment (“elective recovery”), and in this article, I will discuss how technology can support this objective.
1 Find out who still needs treatment
Validating whether those on the waiting lists still require treatment, or are still eligible, should be the first step for elective recovery. Some patients may have decided to not have the procedure, have had it elsewhere, their condition may have worsened, or they may have developed co-morbidities. This might mean that another procedure, perhaps more complicated, will be required and that they should now be added to a different waiting list. Sadly, during the waiting period, some patients may have died and will need removing from waiting lists.
Good data and integration is necessary to manage and keep the lists up to date. To validate those on waiting lists, patient engagement platforms can be used to send assessment forms to patients and find out their preferences for treatment and their current clinical condition.
The use of these platforms, combined with video consultations and follow-up calls will not only help with ensuring the right patients are on the right list, but may also go some way to reassure patients who feel anxious and frustrated that they have waited many weeks or months to hear when procedures might be scheduled. Patients don’t know who to call to ask and get irritated when, for example, their GP does not have the answers.
The use of online consultations also mean that clinicians can determine whether past investigations need repeating or if additional ones are required. Patient engagement platforms allow organisations to obtain consent, schedule appointments at an appropriate time and place and provide patients with helpful guidance about their treatment.
2 Sort and prioritse the list
Once the patients that do still require treatment have been identified, and are on the waiting list for the correct procedure, the next challenge is to prioritise them. A platform like Infinity is ideally suited to this and easy to use.
Infinity gives visibility of the detail of waiting lists, supporting prioritisation. Using dashboards, patients can be segmented by speciality, required procedure, geographical location, and time spent waiting, as well as priority status, referral status and more.
Relevant staff across the organisation have visibility through Infinity, so it is easy to analyse each list and manage the order in which procedures are performed.
3 Coordinate care
Once a patient enters the appropriate clinical pathway, the next challenge is to coordinate care as efficiently as possible.
Most hospital staff use paper lists and handwritten notes for day-to-day care coordination, which can be time-consuming and risks tasks being missed. If the NHS is to increase efficiency to achieve its aim of reducing the backlog, organisations need to move to digital systems that allow staff to see and share information in real-time, instead of logging onto multiple systems and using paper.
Infinity facilitates planning and coordination of care and procedures. Tasks for patients can be automatically or manually created based on standard patient pathways and assigned to appropriate teams. Tasks might range from preoperative assessments and investigations to clinical review and patient-initiated assessments and follow up. Automations can move patients to the next stage of the patient pathway based on the outcome or completion of a previous task.
Staff can update the status of tasks on Infinity in real-time, or tasks can be automatically updated via technical integrations with third party systems (e.g. the EHR). This means it is clear where the patient is on the pathway, any delays can be identified quickly, and no task is missed or duplicated. Standardisation of tasks on a clinical pathway drives best practice so that the right people are doing the right things at the right time, in the right order. Time is saved chasing data from multiple systems and busy colleagues.
4 Monitor and act on further delays
Granular-level data collected by Infinity is useful not only for audit of clinical activity, but also to monitor demand, capacity and delays in real time to optimise services.
Managers and clinicians can see how many patients are at each stage of each pathway and understand where it may be possible to reallocate resources or offer some patients treatment in an alternative location to reduce their waiting time.
Elective recovery is a pressing priority for the NHS and isn’t going to be successful without effort and investment. Although it might seem a daunting task, there are excellent digital tools available which, in collaboration, could help overcome the NHS’s waiting list problem. Infinity is one of them.
I, and the rest of the team at Infinity Health, are ready to help and can deploy our solution within a few weeks. If you’re interested in learning more, or would like to discuss your elective recovery challenges, please get in touch: hello@infinity.health
* https://www.bma.org.uk/advice-and-support/nhs-delivery-andworkforce/pressures/pressure-points-in-the-nhs
