How we’re reducing the time you’ll wait for treatment
We’re proud of how all our teams are working hard to reduce waiting times for our patients to get the treatment they need. The pandemic provided the impetus for them to innovate and change and our work continues to be endorsed by senior NHS colleagues.
On a visit to our Elective Surgical Hub (read more about the hub below), Sir David Sloman (pictured below centre with our team), Chief Operating Officer at NHS England, said: “The Trust is doing some brilliantly innovative things. It was a pleasure to visit a unit that is clinically led, patient centred and driven by a leadership that is absolutely focused on improving things for staff and patients alike.”
And after seeing all our hub had to offer, Chris Hopson (below, right), Chief Strategy Officer at NHS England, said: “The positive benefits of the hub model for workforce enable a really effective use of both nursing and physician associates – for example, four advanced physician associates covering the entire hub provides a high quality of continuous care, supporting consultants very effectively. The trainees also love it as it gives them a very good training experience.
“Works for staff, works for patients, works for the taxpayer, impressive!”
Others in the NHS have been in touch to learn from us, and we are one of the best performing London trusts when it comes to the delivery of high volume, low complexity surgery.
Our teams have thrived on mutual respect, visible leadership and a shared determination to deliver for our patients.
From super-clinics in the evening and weekends through to state-of-the art diagnostic equipment and streamlining ways of working, staff have turned what they learnt from Covid-19 into what they do each day as they tackle the backlog.
The results have been impressive. The surgical hub carried out more than 7,600 surgeries last year; and, having reduced the number of those waiting more than two years for treatment to zero by July 2022, we've hit another milestone by reducing the number of patients waiting over 18 months to zero.
This was despite challenges including the strike by junior doctors leading to delayed appointments.
Our Chief Executive, Matthew Trainer, said: “We have worked incredibly hard to reduce to zero, by the end of March, the number of people waiting more than 18 months for their treatment.
“This is a brilliant achievement – well done to our teams who have gone above and beyond to make this happen.”
We are one of the few trusts to hit this target and are incredibly proud of how hard all our teams have worked to achieve it. Read more.
Our Elective Surgical Hub at King George Hospital
This hospital within a hospital is one of our greatest assets. The importance of our focus on maintaining surgery in our hub is borne out by the fact three out of every five of our surgical admissions (via A&E) were on a waiting list of some kind. It’s where we are focusing on the six specialties that make up 70 per cent of our waiting lists - general surgery, ENT (ear, nose and throat) trauma and orthopaedics, ophthalmology, urology, and gynaecology.
It has enabled us to keep surgical beds free for patients waiting for their planned care, instead of being used for emergency cases which has often been the case in the past.
Our hub is one of just eight across the country to be accredited as part of a national scheme which recognises high standards and a commitment to offer training.
Following a visit from members of NHS England's national accreditation team in February, a panel met before official accreditation was given in March. It is now hoped the scheme will be rolled out to surgical hubs across the country.
Work has also begun on a £14m expansion of the hub, which will include two new theatres, allowing us to carry out at least 16 additional operations per day, as well as upgraded staff facilities, improved storage, and double the number of recovery beds.
Innovations benefitting patients
Our Urology department can see up to 50 patients a week following the launch of a new state of the art ESWL (Extracorporeal shockwave lithotripsy) machine at King George Hospital.
Before we used a mobile machine from a third-party, which meant we could treat just 10 patients and only on Saturdays. The launch of the ESWL machine means we can treat five times more patients a week.
During Sir David Sloman’s visit to our surgical hub, he unveiled the country’s first robotic colonoscopy machine. It’s making a huge difference to patients like Susan Shalloe, who can’t have conventional colonoscopies.
Unlike traditional colonoscopy, our new robotic machine offers a painless and safer experience. There’s also no need for sedation which means patients can recover almost immediately.
And in a world first, we have partnered with Surgery Hero to give surgery patients access to a bespoke digital platform which helps them prepare for their operation and speed up their recovery. The technology offers personalised education programmes and 1:1 remote health coaching.
Some highlights from our teams:
TonKIDZ and TonKIDZ 2– our ENT (Ear, Nose, Throat) team have slashed the number of children waiting to have their tonsils removed almost in half, after two high volume ‘TonKIDZ’ weeks. During the first,100 operations were carried out, ten times the usual amount – including 20 in a day over the weekend. In the second week, the team exceeded that with 111 tonsillectomies and 10 sleep studies completed. These were aimed at children who suffer recurring episodes of tonsilitis or have sleep apnoea, some who had been waiting up to a year.
Treating our gynaecology patients sooner – we’ve held our second Gynaecology Perfect Week, treating double the number of patients and helping reduce our waiting lists. Perfect Week 2.0 focused on keyhole surgery, removal of polyps, and diagnostic procedures under anaesthesia. During the week, 82 women were operated on.
Saving 16,000 patient visits a year – John Hambidge, consultant orthopaedic surgeon, retired from our Trust on 14 April 2023 and reflecting on his proudest achievements said: “I led a team that established the telephone fracture clinic. By using virtual triage we were able to deal with many of the patients who would usually attend face to face clinics distantly, directing them to physiotherapy, hand therapy, plaster room or other providers directly. This has resulted in a 40 per cent reduction in face-to-face fracture clinic attendances. That is over 16,000 patient visits a year saved!”
Reducing urgent skin cancer referrals to zero – our Medical Photography team stepped in to help our Dermatology department when they were faced with 900 patients waiting for an initial appointment. Increasing demand last summer, up 60 per cent from 2019, meant our team were struggling to get on top of urgent suspected cancer referrals, patients who needed to be seen within two weeks. To help clear the backlog, our Medical Photography team arranged 480 photography sessions for patients over two months. Our Dermatology team also set up a telephone triage clinic. From the peak of 900 patients waiting last October, no patients were waiting on a two-week referral by January 2023.
Theatres 3.0 project - on Thursday 24 November 2022, our Surgery team operated on 22 urology patients in one day, triple the number which would usually be completed on an average day.
Gynaecology ‘perfect week’ – In November 2022, we treated 81 women during a focused effort targeting women who had experienced long waits. It would usually take our team around a month to carry out this number of operations.
PrEYEority week - we held our seventh PrEYEority week in September 2022, seeing 1,153 patients in just seven days – smashing our own target of 800. These focused efforts have reduced our waiting lists and given the team the opportunity to focus on reducing the backlog of children waiting to be seen, launching the ‘Bright Eyes’ project.
Endometriosis Awareness Week – we carried out 24 endometriosis operations in just one week, compared to a usual average of around two a week. This was made possible thanks to the hard work of our team and robotic assisted surgery using our Da Vinci Xi system.
Bones Project – our most recent Bones weeks, in April and May 2022, saw 133 patients get the care they needed. We’ve had five such weeks so far and we haven’t lost any theatre slots as a result of patients failing to attend, helped in part by our surgeons calling their patients the day before they’re due to operate. In the third Bones week in July 2021, we carried out 135 hip and knee replacements in seven days and one person went home on the day of their operation after having had their hip replaced.
Scalpel Project - our General Surgery team held six special Saturday clinics, and saw more than 1,000 patients - one of whom was a 103-year-old woman whose treatment had been delayed by Covid-19.
Back2Backs – our spinal review clinic helped prepare patients in need of surgery. 119 patients were seen on the day. The clinic boasted a one-stop-shop to get patients ready for their procedure.
ENT Kidz - a series of weekend ear, nose and throat (ENT) super clinics for our young patients.
Gastronaught project - brought together clinical and administrative teams to review 636 patients not yet booked for appointment. 51 per cent of them were either redirected or discharged and all the others were booked to be seen or had investigations planned.