In over the summer of 2021, the CQC asked 73 trusts about their approaches to longer waiting lists and how they were considering people’s care in a “fair and equal way”. Their aim was to gauge Trusts’ assessments of the challenges, such as the suspension of some elective care caused by increased pressure on hospital capacity during the pandemic, and other challenges such as the need for more extensive infection and control measures, an increase in the number and intensity of cleaning procedures, the use of personal protective equipment, and enhanced testing.

Subsequently, as autumn brings the pre-cursor to winter challenges, the CQC published the results of those questions in a report that reveals the full extent of the challenges faced by NHS Trusts and reveals the importance that digital transformation and technology played in how they are working to deal with them.

The Challenges

Perhaps unsurprisingly, the report showed that patient access to elective care was very seriously affected by the COVID-19 pandemic, as many NHS trusts had to ensure that they could continue to provide critical care instead. In addition, that critical care was increasingly provided using theatres and other spaces that might previously be used for non-urgent care, and key staff, such as anaesthetists, were transferred to critical care during the height of the pandemic.

Hospital capacity was also under pressure due to social distancing, infection prevention and control (IPC), cleaning measures, use of personal protective equipment (PPE) and enhanced testing. As a result, hospital waiting lists for elective and outpatient care increased across the NHS, with Trusts reporting that their prioritisation was focused on those people with the greatest need and those that had been waiting the longest – using prioritisation codes to prioritise their waiting lists by giving them a clear view of the number of people waiting, the urgency and which speciality.

Many Trusts reported their positions as "hugely challenging" but recognised how critical it was to maintain proper governance and oversight of the process to ensure that no patients were being missed, guard against inequality and maximise capacity, as well as continually reviewing waiting lists.

Tackling the waiting lists for people’s care will be central to recovery for some time to come, but it’s been made more challenging by the fact that some hospitals are still experiencing high levels of COVID-19 patients, with intensive care unit beds and operating theatres used for these people, and with social distancing and IPC arrangements reducing the capacity of hospitals, especially for those with older estates or reduced space.

Many Trusts are also experiencing significant staff vacancies in key areas that they are struggling to fill, and are seeing growing concerns about the wellbeing of their remaining staff who increasingly have to take annual leave as they could not be expected to continue to work at the current pace.

Tackling waiting lists

Trusts tackled waiting lists in a variety of ways, but all trusts reported that the pandemic had accelerated their use and implementation of virtual outpatients, with virtual, online or telephone appointments accounting for as much as 60% of all activity. Kettering General Hospital NHS Foundation Trust, for example, reported that their virtual appointments went from 17,000 in 2019 to 160,000 in 2021.

Trusts also pursued other digital solutions such as home testing, remote monitoring and portals and apps to allow patients to access information, advice, correspondence and manage their appointments. The report also spoke about quality impact assessments and patient satisfaction surveys to ensure that patients were receiving a good service – and some also talked about training and support for consultants to ensure they felt confident in the skills required to work in a digital way.

One of the key things that the report revealed was that technology and digital solutions were – and are - a significant part of Trusts’ plans for helping people who need care while tackling their waiting lists. This was shown via a number of examples of digital transformation programmes and digital pathways that helped to provide good outcomes for patients, such as an interactive digital outpatient platform within orthopaedics that enabled patients to track their post-operative recovery, check in on any changes in condition and request follow-up or advice and guidance rather than having traditional face-to-face reviews, or in the way in which one Trust changed their delivery of a cystic fibrosis service to keep patients safer at home by moving to a fully digital care pathway that allowed them to still admit patients to hospital as required.

Other examples of new digital solutions stated by Trusts include use of patient portals for accessing video consultations, appointment information, appointment reminders and a limited patient held record, as well as use of NHS e-Referral service that enables patients to manage their appointments.

Opportunities

It’s clear then, that while the pandemic has caused enormous stress to the health and social care system, the right technology and digital solutions can help Trusts along their journey on the difficult road to recovery. Trusts have made it clear in the CQC report that a reliable, versatile digital solution to quality assurance and risk management would be hugely beneficial in tackling the challenges that face them, especially in the light of continuing staffing and staff wellbeing issues, which in turn have significant knock-on effects for the availability of care and the ability to reduce waiting lists.

By using a single, unified platform – a solution like InPhase Oversight - Trusts will be better able to tackle many different individual aspects of the recovery journey, including reviewing and understanding their waiting lists, streamlining the way they deliver services, and making it easier to monitor staff wellness and the effectiveness of improvement actions.

InPhase Oversight allows Trusts to improve any one of these aspects individually or improve all of them together in a flexible, integrated way, giving them the greatest advantage possible in their journey to beat the backlog and work towards recovery. Contact us today to start your digital transformation journey and see how Oversight can help deliver maximum quality assurance with minimum fuss.

Robert Hobbs

Chief Executive Officer

InPhase’s Chief Executive and Founder, Robert has been the visionary leading InPhase to be one of the UK's leading providers of management, governance and assurance solutions, and helping organisations align their actions and goals more easily and efficiently with InPhase's suite of integrated apps.