The pandemic not only saw a rapid increase in the numbers of patients waiting over 18 weeks for treatment, but for this high-profile trust in North London the second wave placed significant pressures in their initial restoration efforts.
The Trust saw their own clinicians redeployed to frontline duties to manage the Covid surge of admissions stopping theatre activity and extending waits for care for Elective patients increasing the risk of deterioration to their conditions. There were significant staffing gaps within theatre nursing and anaesthetic teams, even with surgeons willing and able to run additional theatre sessions.
The North London Trust partnered with Medinet following endorsement from NHS England / Improvement as part of a wide London restoration project at the end of 2020. We were certified as being the only insourcing provider with suitable capacity, experience, and expertise to support the centrally funded project.
Preference was given to Medinet’s insourcing model rather than outsourcing to a local private hospital due to the greater value from operating under tariff as well as the desire to optimise the local estate capacity. This also enabled patients to be treated in their local hospitals and remain in the local NHS pathway with the Trust maintaining control of the patient journey and patient record.
Initially Medinet provided additional teams working within underutilised to optimise the local estate capacity but once the second wave of the pandemic hit, local teams were sent to the front line stopping all planned care services in key specialities.
Working jointly via a multidisciplinary approach, Medinet backfilled lists to keep patient lists running across weekdays and weekends as a true 7 day NHS elective care service so patients could continue to be seen and treated. This partnership approached also meant that both parties could ensure the high volume of patients the service needed to treat met all local and national social distancing measures.
As the service developed, many several surgeons wanting to treat their own patients and willing to support extra capacity, Medinet developed a hybrid staffing model. This allowed the trust to onboard local consultants to work with Medinet staff, ensuring more patients were treated by their original consultant and enabled a more complex case mix to be included in the contract including ASA3 category and inpatients. To date we have worked across 7 different specialities and provided additional outpatient capacity.
Working in a true partnership fashion, the North London Trust and Medinet multidisciplinary teams engaged from the start to ensure that clinical, governance and operational capabilities not only matched but were also aligned to the needs of the Trust.
Regular weekly calls with all key stakeholders (clinical, governance, ops and commercial) from both Trust and Medinet to review previous week delivery, address any barriers to success and agree actions, next steps and plan for forthcoming week(s). This has enabled us to not only understand more clearly, but also to align more effectively with Trust pathways in order to deliver a safe, efficient and valuable service with the patient at the heart of every decision.
The development of a working partnership has enabled us to develop further outpatient clinic services including those in Gynaecology and ENT.