During the pandemic the waiting list, and the patients waiting over 18 weeks for treatment, grew by over 14,000 patients, which put significant demand on the local teams to find additional capacity and treat the most urgent patients. The Trust had physical estate to optimise but struggled with the additional staffing to run elective sessions, as clinical teams were redeployed to manage the Covid surge of admissions. There were significant staffing gaps within theatre nursing and anaesthetic teams, even with surgeons willing and able to run additional theatre sessions the local teams didn’t have the additional staff to resource the empty theatres. The clinical admin teams were also heavily impacted by Covid with staff on redeployment and higher staff sickness levels. If additional clinical capacity was to be found, additional admin capacity would also be required to ensure the extra capacity was well utilised.
The Trust partnered with 18 Week Support to optimise the local estate capacity, rather than outsourcing to a local private provider. This enabled patients to be treated in their local hospital and reduced the admin pressures of duplicating patient records on multiple systems. The programme was launched with the 18 Week Support senior productivity lead; during day 1 of the engagement the lead met with every operational manager to confirm backlogs, establish available estate and discuss any blockers to success. For several specialties booking capacity was a real concern, therefore 18 Week Support booking teams were deployed and embedded into selected specialties to help with both 18 Week Support lists and the weekday local sessions – ensuring the Trust utilised all available sessions, not just the additional insourcing ones.
During week 1 of the engagement additional site visits were completed by the 18 Week Support Lead nurses to ensure the proposed estate would allow the high volume of patients the programme needed to treat but with social distancing measures in place. Clinical Leads from the trust and 18 Week Support finalised pathways and agreed communication links for the engagement. With several surgeons wanting to treat their own patients and willing to support extra capacity, 18 Week Support developed a hybrid staffing model. This allowed the trust to onboard local consultants to work with 18 Week Support staff, ensuring more patients were treated by their original consultant and enabled a more complex case mix to be included in the contract.