As NHS leaders begin to think about recovery after the pandemic, it is vital to take appropriate actions now to prepare for the expected growth in elective waiting times and the potential impact on patient safety, writes Karina Malhotra.

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As the country navigates its way through the crisis faced from the spread of covid-19, the pressure is very real for the NHS. Although the focus now is quite rightly on reconfiguring the NHS to respond to the pandemic, it is imperative to start thinking about the return to normality further down the line, and what actions we can take now to minimise the recovery period.

As noted within the HSJ, the rapid coronavirus response could create ‘very serious unintended consequences’. This is likely to particularly impact outcomes for patients not directly affected by the virus but whose treatment has been delayed due to the response effort i.e. those awaiting elective treatment.

The elective waiting list already stood at 4.4 million patients before the outbreak, the highest figure since the referral to treatment pathway began in 2007, and now further growth is inevitable.

Data quality within the elective care waiting list may not seem to be the top priority right now; but we, at Acumentice, believe that it will play a significant role in Trusts’ recovery efforts. More importantly, to patients’ outcomes and their lives. When the fog of war from the coronavirus has lifted, every Trust is likely to be facing increased waiting list sizes holding more long waiting patients with potentially deteriorating health conditions.

Accurate and comprehensive data on these waiting lists will be the only means to track and monitor patients whose treatments have been deferred. Without appropriate action now to manage patient data, the corrective recovery could take an enormous amount of time and resources putting further pressure on the NHS.

If an organisation cannot trust its data as it recommences elective activity, how can it be assured it is prioritising the most clinically urgent patients first, and ensuring that the right patients are seen in the right order?

To this end, we are working closely with our NHS partners on multiple projects to keep their data clean and start to plan for recovery from the pandemic. Being ex-NHS senior leaders with decades of operational experience, we understand the complex systems that need to be shaped effectively to respond cohesively to this challenge. Here, we list the most effective actions we are working on with our partners to keep patients safe.

Developing clinical prioritisation protocols – NHS England and the Royal College of Surgeons have published surgical prioritisation protocols on their website to support Trusts commence this work. Non-admitted pathway prioritisation is important to consider too. Recording and monitoring of all prioritisation should be organised through Trust digital systems to support tracking.

Recording detailed deferral rationales - All patient deferrals should be recorded with appropriate details on Trust digital systems and correlated to clinical prioritisation. This will support immensely when recommencing elective activity to track individual patient circumstances.

Integrating virtual pathway management processes – Whether managing new referrals or follow up outpatients, it is important to have a clear operational and data recording process map in place. All diagnoses, prioritisation and outcome details should be recorded on Trust digital systems to support monitoring patients effectively.

Enhancing elective care data dashboards – Most Trusts will have data quality dashboards already – it is important now to enhance them with a particular focus on all indicators that will support tracking and monitoring patients deferred during this time based on clinical priority.

Refining data cleansing strategies – Based on data dashboards, Trusts should augment data cleansing and validation strategies to ensure any issues identified in data entry are quickly tackled.

In addition to such immediate interventions, this situation will also benefit from provider organisations coming together and considering sector wide interventions to support recovery.

We founded Acumentice with the core aim of using data and digital innovation to improve patient and staff experience in the NHS. The same ambition has allowed us to effectively engage in the covid response effort with NHS partners, including volunteering our expertise on the operational front line. As this crisis unfolds, we remain very proud to be working with the NHS to develop resilience as they plan for recovery now.

If you would like more information or want to talk about how we can help please do get in touch.



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