Blog | How are operational teams tackling the backlog within NHS Trusts?

As the NHS begins to scope out its recovery following the first wave of the coronavirus pandemic, a new framework has been released to help Trusts tread the fine line between reducing the outpatient  backlog, restarting elective surgeries and maintaining enough capacity to deliver critical care in the event of a second wave of COVID-19.

To strike this delicate balance, a robust operational and organisational approach to implementing the ‘new normal’ is key, says Intouch with Health Chief Operating Officer, Kevin Fletcher. We spoke to him to find out more.

You’ve spoken at length in recent weeks with NHS COOs as they try to establish how best to resume / restart planned operations. What are you hearing?

That striking a balance is crucial and their biggest challenge – meeting patient needs and addressing priorities. There is an acute awareness of the huge backlog of clinic appointments and elective surgeries, and the possible ‘overwhelm’ that it could create. Trusts are trying to establish how to balance processing this backlog while preventing and controlling the possible spread of infection. They are also reviewing and considering what needs to happen from an operational and organisational perspective, and are aware of the opportunity to embed operational improvements from here on in.

What are the main operational focuses for change that are being considered?

Expectedly, there is a specific operational focus on segregating patients that have tested positive for COVID-19 from those that have not – and from patients who might, as-of-yet, be undiagnosed. Many Trusts have realised the benefits of virtual patient interaction after having quickly adopted ‘digital-by-default’ solutions including video consultations.  They are looking at how this can be further extended and integrated into secondary care pathways to support elective surgery and the management of long-term conditions.

Some patients who are required to physically attend hospital are being encouraged to wait outside the hospital, in their car for example, and check-in / wait to be called for their appointment via a mobile app – therefore avoiding waiting rooms. Patients can now also be asked specific COVID-19 questions when checking-in, redirecting them if necessary, depending on their responses. Patient flow processes like this supports social distancing practises, minimising contact between patients and staff where possible.

There is also a shift towards the permanent integration of solutions including virtual consultations and home-based pre-operative questionnaires, spurred on by the benefits these solutions have proven they deliver as part of their rapid adoption in recent months. We have been working closely with Trusts to prepare for the introduction of Synopsis Home as they move into the ‘recovery’ phase and restart elective surgery. In practical terms, this not only streamlines workloads for clinicians and staff who are already exhausted after the first wave of COVID-19, but it also helps to significantly reduce the number of patients that physically enter a hospital building for the long-term, thus helping to prevent and control any potential spread, and contributing to objectives in the NHS Long Term Plan.

Having faced unprecedented workloads in recent months, is there a worry that Trust teams could be taking on too much, too soon, by deploying new technology in a bid to try and recover and re-start elective procedures?

I think this is certainly weighing on the minds of many Trust staff, especially those in operational roles who are being challenged to balance finding solutions that deliver the ‘new normal’ ways of working while ensuring that any new technology deployed isn’t done so too quickly.

The pace of transformation driven by the pandemic has given the encouraging nudge of confidence some operational teams perhaps needed to realise what can be achieved, but we’re not quite out of the woods yet with COVID-19. Some Trusts are looking for ways to test the water through phased introductions to new technology that can be scaled later to really ramp up their digital transformation.

Healthtech suppliers need to respond to this and adapt their solutions to help operational teams build confidence in what could be achieved. Our own Reset Pathway is a result of our in-depth knowledge of the nuances of the NHS and several consultations with operations teams who expressed a desire to try ‘lite’ versions of our solutions that deliver benefits immediately but don’t require huge amounts of resources, time or training to deploy. Approaching things this way then gives Trusts the flexibility to scale towards full product functionality and integration when they are ready to grow, using an eco-system of integrated solutions that facilitate long-term change.

How are you seeing Trusts approaching the recovery phase with frontline clinical staff?

Empowerment is key here. The Trusts I’ve spoken to and worked with realise that ultimately, the staff that use the technology every day are the key to its success. They must be confident and fully ‘bought-in’ to the solutions they’re using and able to clearly see how it makes a difference to their roles.

If we take a holistic view of the outpatient journey, patient flow management is a prime example. It is an area where many operational teams realise they can bring front line clinical staff on board, by giving them access to technology that maximises their resources and minimises their unnecessary administrative tasks; technology such as a digital room and resource manager, an electronic outcome form or even virtual / remote patient self-check-in.

Focusing specifically on the ‘admin’ leading up to elective surgery, home based pre-operative health questionnaires completed by patients and then made immediately available to triage teams digitally, allows staff to take decisive and clear action based on information made readily available from the patients themselves. This empowers staff to help drive down unnecessary POA (Present on Admission) attendances in line with the NHS Long-Term Plan, while freeing up more of their time to focus specifically on patients who require care or intervention prior to their operation.

What comes next for digital transformation in the NHS?

Many operational teams do not want to revert to the ways of working before the pandemic. Most are now seeing the opportunity to reset processes and make long-term change that has been kick-started with short-term solutions. However, as Intouch CEO, Mike Sanders wrote in his recent blog, if new technology serves limited functionality within the healthcare environment, we risk ending up with a portfolio of disjointed solutions that will only serve to stifle change and impede operational efficiency, not deliver it.

Suppliers and Trusts must therefore work closely together in the coming months to establish pathways to manage the backlog of elective surgery, setting clear and measurable objectives and using introductory, ‘lite’ versions of available technologies, where appropriate, to help test the water comfortably and ensure positive operational changes can be delivered and embedded for the future.  This phasing-in of solutions will deliver what is needed and build confidence for staff, without yet more pressure on our already hard-working NHS.

Contact Kevin to learn more

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Tackling the backlog