Topics: Industry insights Elective Backlog Recovery
In our previous article, we explored the plan to tackle the NHS waiting list crisis. Amidst the associated challenges, a theme became clear. The NHS needs to balance the ambition to create additional appointments with tackling the underlying issues - all without further straining the existing workforce. To address this, we turn our attention to sustainable solutions for elective recovery.
Elective recovery in the NHS requires a shift from traditional methods to a more integrated approach that maximises resources and enhances patient care, prompting the question: where is the greatest potential impact?
Addressing contributors to the backlog
While all stages of the patient journey are important, follow-up appointments, which account for more than 60% of outpatient visits, hold the most potential for impacting elective recovery. They often create "hidden waits", where patients face delays between necessary investigations and further visits. For example, neurodevelopmental assessments require multiple visits, which can extend the wait between initial referral and diagnosis or treatment.
For patients, prolonged gaps can lead to worsening conditions, more complex care needs, additional follow-up appointments, or, in severe cases, emergency visits to A&E further compounding the demand on frontline staff. Such escalations lead to significantly increasing costs to the NHS the longer they are left untreated and unmanaged.
To mitigate these issues, the concept of "waiting well" becomes crucial. Much like how services such as Uber Eats or Amazon Prime keep customers informed and reassured with regular updates, healthcare systems can apply similar principles to keep patients engaged and at ease during their wait. By providing timely and transparent communication, the NHS can help patients feel more in control of their care, reducing anxiety and improving overall patient satisfaction while they wait for care.
Prioritising effective follow-up management, alongside new appointment management, shows promise for alleviating the current bottlenecks. But how can we achieve this sustainably while empowering patients and service users to "wait well"?
Better care is possible through hybrid healthcare
Hybrid healthcare balances traditional patient pathways with modern digital processes, transforming patient journeys and scaling services to meet demand without overburdening NHS staff or compromising the patient experience. By effectively combining these methods, hybrid healthcare addresses both patient and clinician needs, optimising the use of existing resources and providing a sustainable solution to tackle the backlog.
So, the next question is: which innovative tools can the NHS implement to enhance elective recovery?
Tackling the backlog for new appointments
Connect the dots between referral and treatment with eMeet and Greet (eMAG)
eMAG is a key component of the NHSE initiatives under the Elective Recovery priorities. It plays a crucial role in providing patients with the reassurance they need and keeping them informed throughout their care journey, from referral to appointment.
Traditionally, confirming a patient's referral often involved phoning them, sending letters, or, in some cases, failing to communicate at all. These methods are not only time-intensive for teams but also prone to manual error, leading to unreliable outcomes and unnecessary stress for patients.
In contrast, eMAG offers a more streamlined approach. By automating the onboarding process, futile admin tasks are reduced, and patients are proactively kept informed. Currently, up to 30% of patients contact hospitals directly to seek updates regarding their referrals. By allowing booking teams to manage and confirm multiple referrals at once, integrate with the NHS App, and even send out online forms to assess demand and manage capacity, inbound calls are significantly reduced.
Optimise waiting list validation and triage processes with digital
Traditionally, waiting list management was more a rarity than common place.
The processes were often heavily manual and time-consuming. Booking teams and clinicians would review waiting lists and records and prioritise care. The challenges were similar to booking teams effectively confirming a patient's referral.
This traditional process also lacks the agility needed to respond to real-time changes in patient circumstances. Communication with patients relies heavily on outdated methods like phone calls and letters, leading to delays and Did Not Attends (DNAs).
Digital-led waiting list validation combat these manual, time-consuming processes to help Trusts and Health Boards quickly regain control of their waiting lists. By communicating with patients online and via their preferred method of contact, patients can be easily reached and validated at scale. Online methods of data capture such as assessments and forms also allow clinicians to accurately triage and prioritise the delivery of care based on up-to-date patient data.
Many NHS Trusts and Health Boards across the UK have reaped the benefits of embracing digital-led processes. Working alongside the National Elective Coordination Unit (NECU), we helped seven Health Boards validate over 81,000 patients, contact 4.4x patients in one-third of the time and save £3.57m in cost avoidance - all in just six months.
As for patients? Data-driven validation and triage processes mean shorter wait times and more accurate prioritisation of care, helping them feel more at ease. Instead of waiting in uncertainty for updates on their referral, they receive timely and informed updates that keep them reassured throughout their care journey.
Sustainably managing follow-up appointments
Improving follow-up management with Patient Initiated Follow-up (PIFU)
By aligning clinical resources more effectively with patient needs, scaling digital PIFU across the NHS can be one of the biggest drivers in tackling the backlog of follow-up appointments. By inviting eligible patients to request follow-up appointments when they need one, digital PIFU enables teams to understand how many patients on average request an appointment, which can be applied to plan capacity more accurately.
This reduces potential concerns from teams being overwhelmed by unplanned patient requests for appointments and helps keep a level of transparency with patients, who no longer feel 'lost' in a system - as can often be the case with overloaded waiting lists.
Similarly to digitising waiting list validation processes, the information gained from digital tools on PIFU pathways help determine urgency and make more informed resource decisions. This helps reduce unnecessary follow-up appointments and frees up capacity for urgent cases, helping NHS more make meaningful strides toward sustainable elective recovery.
Unlock the potential of remote care
The current process for healthcare delivery in many Trusts heavily relies on in-person appointments. This traditional approach often requires patients to travel to hospitals or clinics for consultations, follow-ups, and routine check-ins. While necessary in some cases, this process can present significant challenges, including logistical difficulties for patients, increased risk of DNAs, and inefficiencies that contribute to longer waiting lists and an overburdened NHS.
Remote care is revolutionising healthcare delivery by offering greater access to care. Video consultations, for example, enable patients to attend appointments from the comfort of their homes. This is particularly beneficial for follow-ups and check-ins where the quality of care is not compromised. This shift enhances patient convenience while reducing the strain on the NHS.
Clinicians can also leverage video to conduct virtual reviews, assessing a patient's digital form to determine whether they are stable and don't need an appointment, need to be seen face-to-face or have a phone appointment.
When combined in a PIFU pathway, teams can deliver an highly impactful blend of patient-initiated follow-up with clinician-led, triaged, data-driven follow-up.
Integrating remote care options enables clinicians to manage mixed clinics that combine in-person and virtual appointments, optimising schedules without extending working hours. This keeps waiting lists moving and reduces DNAs by providing a more accessible alternative for patients facing barriers to in-person visits.
Patients benefit from the flexibility and convenience of remote care, progressing through their journey more quickly, with reduced wait times and no need to travel.
Leveraging AI and automation
At present, increasing productivity in clinics means asking an already overstretched workforce to work harder or longer hours. This is unviable, leading to burnout and a decline in the quality of patient care. Complementing manual tasks with digital tools like AI and automation allows clinics to follow a sustainable path to improvement without putting more pressure on staff.
AI plays a crucial role in optimising clinic operations by predicting the likelihood of DNAs, allowing for the safe overbooking of clinics. This ensures that appointment slots are well utilised, reducing waste and ensuring that clinics remain productive and cost-effective.
Upgrading manual call outreach with automated voice can help support busy teams reach patients to confirm their need for an appointment - and has quickly been demonstrating its impact. In one pilot, Automated Calls helped reduce a clinic's DNA rate by 20%, saving 5 minutes of admin time for each successful engagement event (when a patient confirms, cancels, or reschedules their appointment).
To further alleviate the workload on teams, combining and automated repetitive operational processes into digital workflows helps simplify pathways and reduce the risk of errors and manual rework, freeing up teams to focus on more of what matters: delivering quality, personalised care to patients as quickly as possible.
A sustainable future for the NHS
Building a long-term follow-up management process goes beyond addressing immediate backlogs; it's about creating a system that adapts to changing demands and supports the NHS in delivering high-quality care while maximising the effective use of resources.
Traditional methods struggle to keep pace with the NHS's evolving needs, leading to inefficiencies. By integrating traditional patient pathways with digital-led, scalable solutions, the NHS can create a lasting model for elective recovery. It will become adaptable and responsive to future challenges, while patients will be empowered to wait well and receive the support and transparency needed to manage their care journeys effectively.