Background

Medacs Insourcing teams were called upon to support a busy surgery unit, nationally recognised for best practice, currently seeing around 12,000 surgical cases per year. 

Post-pandemic, this Trust was facing a significant Referral-To-Treatment backlog, with over 43,000 patients waiting for non-urgent elective operations, treatment or their first consultant-led outpatient appointment.

14% of patients on the list had been waiting longer than a year and the Trust needed a significant increase in activity to continue to keep waiting lists in line with national targets.

Solutions

Medacs initially built a new managed outpatient service for Gastroenterology patients, and went on to manage regular weekend clinics across four specialties, supporting Colorectal, Urology and Gynaecology patients. A full clinical coding service was also provided for the latter.

Unlike traditional clinical insourcing services, Medacs supports the use of local Trust staff, with extra out-of-hours work offered first to substantively employed consultants and nurses, and a small pool of extra clinical staff brought in to support and fill gaps.

This ‘local’ workforce model aided continuity of care for the Trust, with patients seeing the same consultant in follow-up sessions. Care pathways were also more efficient, with familiar local staff more able to easily access interlinked services. 

Results

Medacs coordinated hundreds of extra outpatients clinics, clearing more than 2000 patients and running ‘super clinic weekends’ with up to 11 concurrent clinics. Within 12 weeks, 162 patients were cleared from the 78-week waiting list for Gynaecology alone (50%). This enabled the Trust to divert resources to 2ww cancer reviews. A ‘per case’ payment structure has also improved productivity with at least 2 more patients added to each scheduled list.

As a result of the support, the Trust successfully reduced their overall waiting list by 42%, and their 52-week waiting list by 62%, achieving 3rd position out of 25 Trusts in the first cohort of the GIRFT Further Faster programme.