How to get more activity from what we have, by being smarter

The elective recovery planning supporting guidance released earlier this month outlines the plan to recover services, create additional capacity and change the way services are delivered, while giving patients more control. It outlines targets to eliminate the longest waiters, increase diagnostic testing, prioritise cancer treatments and transform outpatient appointments.

With a target of 30% increased elective activity by 2024/25 and additional elective funding now being based on delivery against value-based activity, this extra funding has now got to be earned. Cramming and firefighting won’t work this time – the challenge is too large.

Instead, we need better processes that tackle the root causes of long waits.  At Insource, our solutions already encompass the four key delivery themes set out in the plan:

  • Prioritise treatment based on clinical urgency
  • Expanding capacity to reduce waiting times
  • Transformation to drive productivity encompassing diagnostic centres, surgical hubs, and improved patient pathways
  • Greater transparency on waiting times… and for patients

The foundation for recovery is data

The foundation of elective recovery is data. Data we can trust. We need to know who is waiting, what has already happened along their pathway, and what they need next. Without that, we cannot plan and deliver the right care for the right patients.

At Insource we have been unifying complex operational data for over a decade in the acute, mental health and community sectors. Our technology is a generation beyond the usual approaches. It is faster to implement and more reliable to use. It creates a fully standardised and cleaned Unified Data Layer, regardless of the original data source. This ensures that the uniform data can be merged across sites, systems and sectors, and any analytics will continue to work cross-site.

Smarter working with trusted elective pathways

Elective pathways have an extra layer of complexity because of the multifaceted referral-to-treatment (RTT) rules and non-RTT pathways. Our flagship data management solution, Patient Pathway Plus (PP+), links all necessary data from disparate legacy and diagnostic systems to create a fully validated, single, system-wide Patient Tracking List (PTL) that is more reliable and trustworthy than existing waiting lists.  

This unified PTL provides a true end-to-end waiting list for all specialties, all sites, all the way from referral, through outpatients and diagnostics, to treatment or discharge. It is automatically refreshed and checked daily and becomes the single source of information across a trust or ICS for patient pathway and resource planning.

PP+ combines all waiting lists, no matter the location or speciality, NHS or independent, and ensures fair and equitable access to care.  It also gives full data input to any Health Inequality programmes to help clarify the actual state of play and begin to meet the true needs of the community.

Treating the most urgent first

The two universally accepted rules of responsible waiting list management are: treat the clinical priority patients quickly and book the rest in date order. But there is a risk that multiple siloed programmes working on the same problem with their own copies of part of the data will duplicate efforts and create confusion. Using a single, robust, live waiting list, trusts can easily identify and prioritise treatments based on clinical urgency and length of wait, and achieve safe, fair, and efficient patient booking. This solves one of the two root causes of long waiting times.

Agile capacity and resource planning

The other root cause of long waits is the size of the waiting list, and the elective recovery plan aims to maximise cross-site bed and theatre capacity based on available resources, and news ones, including surgical hubs and community diagnostic centres.  Traditional approaches to demand and capacity planning rely on cumbersome and error-prone spreadsheets, which people struggle to keep up to date.

At Insource our elective recovery suite is both automated and based on the most advanced and deeply researched demand and capacity planning available. It includes agile capacity and bed planning based on acceptable risk, not assumed bed occupancy, and demand and capacity planning along elective pathways to plan the right activity, beds, theatres, and clinics to deliver your waiting time objectives safely.

Streamlining care pathways and improving processes

Our patient journey analytics utilises innovative process mining techniques to clarify existing pathways and identify improvements that streamline patient care.  Processes developed over time and accepted as the status quo are not always optimum and are often confusing and repetitive for the patient.

You may be familiar with process mapping, in which management consultants interview multiple staff groups to build up a picture of how the process might look from a patient’s perspective. This is different. Instead of laboriously constructing how staff say the process works, process mining uses the timestamped data you already have, to reveal what really happens.

Process mining provides an evidence basis for standardisation, to reduce duplication, and provides facts for improving processes and performance throughout the organisation, not just in elective care but in all patient flows and processes for which there is timestamped data. 

Transparency and patient information access

Giving patients greater access to information is also part of the plan, and the My Planned Care platform provides information to patients while they wait for treatment. But My Planned Care is limited by the scope and accuracy of the data available to it and by the unjustified variability of waiting times both between and within clinical services across the NHS.

Patient Initiated Follow Ups (PIFU) also has huge benefits, saving patients from making unnecessary journeys into hospital, reducing the number of outpatient visits that do not add any value, and freeing up clinic time to tackle the backlog. Our data management platform fully supports PIFU.

With the comprehensive and accurate data in our elective recovery suite, and the unrivalled expertise that Insource provide, you can provide near real-time and reliable information to patients and clinicians alike.

For more on see our waiting list management solutions