The problem

The trust needs to investigate its elective waiting lists to ensure fairness, understand the consequences of patients waiting and resource requirements. Otherwise certain patients may receive inequitable delays or have to attend for emergency related treatments, plus we didn’t know what resources were required, which could jeopardise planning and our elective recovery abilities.

The challenge

How can we support our trust to explore, highlight and address the challenges of improving our waiting times and the prioritisation of patients awaiting treatment, so that we can better shape and plan our elective recovery of services and pathways?

The outputs

• The ‘tangible’ output was a tool that provides our trust with a far richer insight into waiting lists, the patients waiting, and the cost/ operational resources required to tackle this.
• The tool provides a brand-new way to visualise and interact with the information in ways that never existed before in their previous pivot table/ data heavy format.
• Combining the tool with a socio-economic lens, calculating resources required and flagging acute attendances that would previously have been an unknown and non-quantified implication of long waits has been, we are told, both transformative and revolutionary.
• Our emergency care clinician is excited by the prospect of the number of research papers this tool can support, while our lead for perioperative optimisation has said it has allowed the trust to understand waits not just by procedure and time, but also by their socio-economic risk factors to better understand the patients who are actually waiting.
• The excitement and real ‘buzz’ that the tool has already generated has energised our ‘art of the possible’, raised awareness of what a costing team is capable of and ultimately increased engagement with PLICS in ways that we had never previously imagined!

The outcomes

Initial deep-dives using the tool have already unearthed some startling findings which include:

• the impact that ethnicity has on average waits. Within one specialty for example, the average wait for black/ black British patients is almost 15 weeks longer than for white patients in another specialty, there is an increased likelihood of patients presenting acutely after waiting over 9 months

• correlations between the primary care network (group of GPs) and acute attendance rate.

These initial findings have really started to spur our trust into action. Our chief operating officer who is keen to increase the specialties engaged with the insight the tool provides, has set aside a large portion of our June 2022 senior leader’s meeting to progress the ‘now what’ as opposed to the ‘so what’.

Topics up for discussion include ‘should we be prioritising patients differently by taking into consideration their area of deprivation or ethnicity?’ and ‘should service provision change to reduce acute presentations to free up more capacity for elective recovery?’