Worst waiting list trust looks to outsourcing

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King’s College Hospital Foundation Trust outsourcing elective work to private and NHS providers
South London provider has highest number of year-plus waiters in England
Orthopaedic and bariatric work being sent to HCA hospital in Harley Street plus NHS treatment centre

The trust with the worst elective waiting times performance is outsourcing work to other NHS trusts and a private provider, and restricting out-of-area referrals.

King’s College Hospital Foundation Trust had 331 patients waiting more than 52 weeks for treatment, according to the most recent data return. This was nearly double the next largest year-plus waiting list, at Leeds Teaching Hospitals Trust.

At a board meeting on Wednesday, directors at the south London provider confirmed most of the backlog was in orthopaedics and bariatric surgery and said it would be looking to outsource parts of this.

Chief operating officer Shelley Dolan told the meeting the trust was talking to Princess Grace Hospital in central London, run by HCA, to take on some of its bariatric work at tariff rate.

Discussions about outsourcing were also taking place with Chelsea and Westminster Hospital Foundation Trust.

Dr Dolan said, like most providers of complex bariatric surgery, the King’s bariatric service was “swamped”. Outgoing chair Ian Smith said the trust would consider restricting referrals from commissioners outside south London. Nearly half of the trust’s bariatrics referrals come from outside the area.

The trust is working with the neighbouring Lewisham and Greenwich Trust to take some less complex procedures off its books.

King’s is already sending elective orthopaedic work to the South West London Elective Orthopaedic Centre, a centre jointly run by the four south west London hospital trusts.

Directors praised the work of the national Getting It Right First Time team, which had been working with the trust’s 32 surgeons to improve the service. Dr Dolan said all but two of the surgeons had engaged properly in the programme in an effort to bring down the waiting list.

King’s has experienced significant problems getting surgical work booked in, with a very high staff turnover in the booking team, the board heard.

Finance director Lorcan Woods told the meeting the 2018-19 financial plan included removing £20m in staff costs, £6m of which had been delivered in-year from administrative and clerical staff budgets.

Despite all the measures taken, the board was told 31 year-plus patients would likely still be awaiting treatment by the end of the financial year, all of them in bariatrics.