Across the NHS, the race is on to reduce elective backlogs and ensure timely patient care, particularly in high-demand specialties such as women’s health. Barking, Havering and Redbridge University Hospitals Trust (BHRUT) has taken an innovative approach to meet these pressures head-on.
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Through a concerted plan to maximise existing resources, invest in the future workforce, and collaborate with chosen partners, BHRUT has rapidly accelerated its recovery in women’s services. Central to this effort is 18 Week Support (18WS), a key enabler that, in the words of BHRUT’s clinical group director of operations for women’s and children’s services, is a valuable “tool in the box” – one that helped deliver tangible results in record time.
BHRUT serves a large and diverse population across multiple sites in east London and Essex, handling significant demand in women’s and children’s services. As part of its commitment to improving patient pathways, BHRUT leadership sought to reduce extensive waiting lists in gynaecology by increasing capacity, improving patient flow, and optimising the use of both existing and new resources.
By late 2024, the backlog in gynaecological services at BHRUT had become one of the largest in the country. Severe staff shortages, coupled with a surge in demand, meant that some patients were still left waiting more than 52 weeks for their first outpatient appointment. Meanwhile, limited inpatient capacity made it difficult to push through complex cases in a timely manner.
Determined to address these issues sustainably, BHRUT leaders took a multifaceted approach that included recruiting more in-house personnel and establishing new initiatives to optimise the trust’s estate. However, they recognised that immediate external support was essential to avoid a further deterioration in referral to treatment performance and prevent additional delays for patients – many of whom had already been waiting far too long. Rather than outsourcing the entire pathway, the trust identified insourcing as a more effective option, allowing for direct oversight of patient care and saving money compared to outsourcing.
Having experienced quality challenges with another provider in the past, BHRUT ran a competitive procurement process and selected 18WS for its affordability relative to other providers, robust clinical standards, and ability to deliver a dedicated booking service. As 18WS was looking to book more than 2,000 patients into the service, the trust did not have the available booking and scheduling staff to meet this demand. 18WS provided a high-performing booking service through a substantively employed team. This ensured that 99.5 per cent of available capacity was filled – a figure notably higher than what is typically achieved by NHS trusts.
As the clinical group director of operations for women’s and children’s services at BHRUT noted:
“The quality of the 18 Week Support booking service was very high. It can be difficult to find high-quality booking and scheduling staff, so it was one less thing to worry about.”
In just three months, 18WS treated more than 2,000 patients, helping BHRUT significantly reduce 65-week waits and avoid a surge in 52-week waiting times. The “see, scan, and treat” one-stop model enabled around 35 per cent of patients to be discharged the same day, compressing what would otherwise be multiple appointments, over six to eight weeks, into a single visit. Meanwhile, the trust’s did not attend rates improved, thanks to dedicated 18WS booking teams. The clinic was scaled up to seven consultant-led rooms running per day, working on a case mix of general gynaecology, urogynaecology, menopause, endometriosis, and diagnostic and interventional hysteroscopies.
BHRUT recognises that insourcing is only part of its longer-term recovery plan. The trust continues to invest in permanent staff recruitment and pioneer new initiatives such as a women’s health hub to streamline services in the future. The clinical group director of operations for women’s and children’s services recommends insourcing for other trusts under similar pressures, citing BHRUT’s experience as evidence that the independent sector can be indispensable. “It absolutely needs to be part of the toolbox,” they note, affirming 18WS’s role in “bridging the gap so the NHS can catch up and get back on track”.
18WS is a leading Care Quality Commission- and Any Qualified Provider-registered healthcare organisation specialising in clinical insourcing and outsourcing services for NHS trusts, integrated care systems, and health boards across the UK. For more than 15 years, 18WS has delivered cost-effective solutions to reduce waiting lists while preserving high clinical standards.
“Constantly innovating, 18WS’s see, scan, and treat model has accelerated access to care across multiple specialties. Having worked in the NHS for over a decade at a senior level, I understand the importance of maintaining oversight and financial control while delivering high-quality patient care. By partnering with 18WS, trusts like BHRUT can do just that; offer timely, safe, and compassionate care through below-tariff services.”
- Omar Shahin, executive director, 18 Week Support.
If your organisation faces similar pressures, contact partnerships@18weeksupport.com for more information on how 18WS can help.
