The Challenge
In June 2025, Shrewsbury and Telford Hospital NHS Trust (SaTH) faced significant elective care challenges. The ENT department was under considerable strain, with a large cohort of adult and paediatric patients awaiting outpatient and surgical reviews.
The Trust was part of a group of “challenged” trusts with RTT performance below the 65% national target. Although the launch of a new Planned Care Hub for day surgery had led to some recent progress, SaTH needed to draft in insourcing support to manage demand, boost capacity and eliminate 52-week breaches.
Solutions
Medacs began by significantly increasing the Trust’s capacity for outpatient appointments, managing regular clinics across two specialties (ENT and MaxFax), typically treating over 200 patients per weekend, with large specialist nursing teams deployed to support specialist Medacs clinicians.
Surgical sessions were subsequently added, focused predominantly on paediatric patients, with experienced specialist consultant surgeons and anaesthetists supplied to work alongside Medacs theatre nurses and the Trust’s substantive teams.
Results
Medacs teams have now coordinated hundreds of extra outpatient and surgical clinics, clearing more than 4000 patients.
Within just 8 weeks, the trust saw a 40% improvement in their RTT position. Six months on, over 60% of patients are now treated within 18 weeks (compared to 38% at contract start) and the 52-week ENT waiting list has been virtually eliminated.
Previously, SaTH were in the bottom decile for their overall RTT performance and the bottom quartile for patients waiting longer than 52 weeks. In December 2025 the Trust was recognised as the most improved nationally for reducing waiting times for planned care and awarded £2 million through NHS England’s Elective Care Capital Incentive Scheme. The ICB is now looking at expanding insourcing support to cover community-based ENT clinics.
