A large Foundation Trust in Sussex had seen its backlog of patients increase across several hospital sites due to the negative impact of Covid-19. Additional capacity was needed to provide procedural support as well as extra outpatient clinics in Colorectal, Dermatology, General Surgery, Gynaecology and OMFS.
The ever-increasing waiting lists across multiple specialties meant the demand on the Trust resources was too great, the Trust were under pressure to keep up with the RTT targets. Our NHS Partner had exhausted in house options using their own resources and had other attempted services that were unable to tackle their backlog.
Medinet worked with the Trust to jointly develop an insourced solution to meet their demands and are currently working with the Trust across a range of specialties delivering both outpatient and theatre services.
THE SOLUTION
To meet the local needs, we undertook a multi-site inspection to map the patient pathways and understand local delivery complexities and understand the delivery needs of each speciality, recommending a staging the mobilisation for a full 7-day delivery model. This is so we could identify any early issues were identified and any lessons learnt immediately implemented across sites and other specialities.
All patients to be seen are ASA 1, and ASA 2. On a case-by-case basis, the Medinet team are reviewing some ASA 3 cases and provided and agreed care package.
The first service, Orthopaedics, went live in early July 2021 providing a full team that included an NHS Substantive Consultant Anaesthetist, ODP/Anaesthetist Practitioner, Lead Nurse/Practitioner, 2 Scrub Nurses, a Circulating Nurse, and 2 Recovery Nurses. We then extended this to Colorectal, Dermatology, General Surgery, Gynaecology and OMFS in late August 2021. Our theatre provision works across multiple theatres and 2 sites.
Working across 3 rooms in one site, we also have an OMFS outpatients service that was mobilised in September 2021 consisted of 3 NHS Substantive Maxillofacial Consultants, 1 Dental Nurse, and 1 HCA to some 1,000 patients.
WORKING TOGETHER
Working closely with the large Sussex hospital, we organised two meetings a week involving a number of attendees from the Trust and Medinet teams. Attendees from the trust consisted of Director and Deputy Director of Operations, Head of Surgery & Critical care, Care Group Manager, Theatre Matron, and Theatre Manager.
Clinical lead from each of the specialties were also in attendance (Colorectal, Dermatology, General Surgery, Gynaecology and OMFS).
Medinet attendees include our Medical Director, Governance Lead, Matron, Operations Manager, and Clinic Coordinator. Through good communication, numerous meetings, and commendable organization from both parties, with a lot of work ‘behind the scenes’ we were able to stand the first service consisting of a full Medinet team to meet all local delivery dates.
Due to the scale and complexity, we have found having regular weekly meetings has worked extremely well in terms of ongoing service and development of new services. This has included undertaking a clinical review of the previous weeks service, and a look forward at the coming week to ensure everything is in place. Communication in these stages is pivotal to ensure everyone has an equal understanding of progress and how we continue to progress.
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