Surgeons working in an operating theatre

Harnessing technology to clear the elective surgery backlog

The rate of technology adoption within the NHS has at times been very fragmented. Some NHS trusts are leading the digital revolution, whilst other trusts have been relatively slower in their uptake. The pandemic has demonstrated that technology can generate significant savings to a trust whilst driving huge efficiency benefits.

With the colossal backlog in elective surgery, healthcare providers are being put under immense levels of pressure to reduce planned care waiting lists, while at the same time maintaining high standards of access to unplanned care services, such as emergency admissions. Can adoption of technology be the key mechanism to help trusts clear the backlog? In this article we will look into how technology can facilitate and support trusts to strategically assess and manage the backlog.

Digital Pre-Operative Assessments (POAs) are a critical part of the entire perioperative process; it is evident that running this element of the care pathway efficiently will play a major role in tackling the waiting list crisis that is currently facing healthcare providers.

A streamlined POA solution can facilitate working through the surgical backlog by successfully helping trusts to evaluate whether patients are fit and ready for elective surgery. By using pre-operative assessments, clinical teams can re-evaluate and re-prioritise patients according to their medical and clinical needs. Historically, POAs are paper-based, often creating difficulties in the streamlining, coordination, and snapshot visibility of patient care pathways, especially if a patient has any complex medical history or needs.

A digital POA allows for seamless coordination between different services and multiple interventions. It tracks any number of clinical tests being organised, medications being prescribed, withdrawn or paused, and enables recommendations such as preoperative optimisation. It can also incorporate information such as which patients may have short-notice availability based on location, current medications that may need to be stopped prior to surgery, rehabilitation needs, and specialist surgical kit required. In conventional settings, such interventions typically require coordination between a range of healthcare professionals, from doctors and nurses to pharmacists and physiotherapists.

Surgeons performing a procedure

A full end-to-end digital POA solution places the patient-clinician relationship at the centre of a smart, accessible cloud software platform ensuring that all clinical information required to carry out each step successfully is always accessible. It also provides convenient links to other services within the patient pathway, prompting the relevant actions by coordinating with those teams. This allows all staff to be reassured that their patients are fully fit for surgery and optimised prior to attendance, thus directly impacting the waiting list, reducing cancellations, facilitating increased utilisation of capacity, and greatly contributing to reducing the backlog.

The British Medical Association (BMA) recently published a report - entitled Rest, recover, restore: Getting UK health services back on track - in which it states that: “If elective activity increased to 120% and 130% of 2019* levels (both of which are likely to be unachievable given current workforce constraints), it would still take several years to reduce the waiting list down to more manageable levels”.

(* the reference to 2019 being to pre-pandemic capacity).

Elective, planned surgery is a central service pillar provided by the NHS.  Any form of disruption to this core service can have direct consequences on service delivery - and the Covid-19 pandemic disruption has certainly had a devastating impact on surgical services in England. Recently published figures indicate over 4.95 million people are currently on a waiting list, and more than 430,000 have been waiting over a year.

In addition, there is also a ‘hidden waiting list’ of people who have not yet come forward or who have not yet been referred for hospital treatment. Estimates vary, but this could mean the waiting list grows to a figure of 9.7 million by 2023/24. The Royal College of Surgeons of England has published a report “New Deal for Surgery'', which highlights the challenges that exist and provides eleven recommendations for recovery.

Among those recommendations was:

  • Ensuring all Integrated Care Systems (ICSs) urgently consider what measures can be put in place to support patients facing long waits for surgery, including the best and most efficient use of new technologies to support this.
Surgeons background image

In summary, the pandemic has expedited the need for a digital POA solution to coordinate the collection of crucial patient data, streamline the assessment process and reduce unnecessary delays, and so assist in reducing the waiting list backlog. The overall adoption of these solutions has gained rapid momentum among healthcare providers, as the true value of digital solutions as a mechanism for reducing the waiting list backlog has become clear.

At the same time, improving communication and collaboration between multi-disciplinary clinical teams, administration teams, and patients has increased the rate at which the backlog can be handled, eliminating delays and improving efficiency across the entire process. A streamlined digital solution enhances information governance and alignment with the NHS Long Term Plan to "put the NHS back on a sustainable financial path".

Open Medical engineers cloud-based clinical pathway management solutions for every speciality - built by clinicians, for clinicians - to collect and process real-time, structured, longitudinal data, from referral to treatment or long-term management.

Read the latest case study demonstrating how West Hertfordshire Hospitals NHS Trust harnessed the power of digital technology to manage its elective surgical backlog.

Find out more by visiting or emailing Open Medical at: [email protected]

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