Teaching trust to outsource electives to tackle emergency demand

According to the trust’s May board report, it will use community capacity but also “utilise the independent sector” to treat displaced elective patients.

Chief executive John Adler told HSJ the trust experienced “significant disruption” to elective care in the most recent winter.

He said: “In order to avoid repeating this, we have changed our approach to demand and capacity planning.

“We are seeking to ensure that we have enough capacity for even peak emergency demand, with the balance available for elective care.”

Mr Adler said the trust has agreed with commissioners that to meet national planning guidance on waiting times, “around 4 per cent” of the elective workload will need to be outsourced.

“The impact of this has been built into our financial plan and there will be no extra cost to commissioners as they will purchase the care at standard tariff prices,” he added.

The trust said it is planning to outsource activity throughout 2018-19 in “a planned way as opposed to the ad hoc way this has been done previously”.

“This includes agreement of a monthly trajectory with commissioners within the next few weeks to ensure that this process starts as early in Q1 as possible,” the report said.

Mr Adler added that the plan to outsource elective care is part of a wider approach to improving emergency care performance, which will also include “opening additional ward capacity and a set of new pathways for patients with frailty”.

HSJ reported earlier this year that UHL was forced to cancel a “significant number” of cancer operations due to a high number of emergency cases requiring care in the intensive therapy and high dependency units, but also because of “general pressure on beds”.

It was later revealed that there were 88 cancellations between December and February as “bed occupancy within all three UHL sites prevented patients stepping down from the [intensive care unit]”.