Surgical Waiting Lists

The Challenge

The fallout caused by the Covid–19 pandemic has had a profound impact on patients waiting for surgery with surgical waiting lists growing exponentially. In July 2020 the BMA suggested an overstretched health service and record high waiting lists prior to the pandemic has led to numbers of patients waiting for surgery climbing into the millions. The conversion of operating theatres into intensive care units and the re-direction of resources have had a knock on effect on other services to accommodate Covid patients.

The BMJ stated ‘The number of people who had been on waiting lists for more than 18 weeks in July was also the highest since records began in 2007, at 2.15 million. Just 46.8% of patients were treated within 18 weeks in July, against the 92% target—the lowest since records began, data from NHS England showed’ (September 2020)

There is now an enormous task to get the surgical waiting lists across the country under control and clear the backlog of patients left behind but not forgotten due to the pandemic.

Dealing with this backlog efficiently and effectively will be a priority over the coming months. There are many factors involved in resolving this situation, all with an important part to play. A robust theatre management system is part of the solution.

Theatreman AQUA

Trisoft’s Theatreman customers have over the years enjoyed comprehensive functionality including scheduling theatre sessions, booking patients onto operating theatre lists and giving our users that ability to look ahead at session availability and operating theatre activity.

As Theatreman is re-developed to create a functionally updated version of the existing Theatreman product, we have an opportunity revisit our customers’ requirements and build a system that meets today’s challenges.

Let’s look at these features and how they meet the NHS current waiting list challenge.

Efficiently moving patients from the waiting lists to a session list and eventually into theatre for their surgical procedure involves many connected systems in the wider organisation beyond just the surgical suite. The specific actions and processes that provide a smooth transition from the surgeons consulting room to an operating theatre can be summarised as follows:

  • Decision to perform a surgical procedure and obtaining informed consent.
  • Placing the patient on the waiting list 0R booking directly onto an available session.
  • Carrying out a pre-assessment to determine fitness for surgery.
  • Transferring the patient to theatre and performing the necessary safety checks prior to surgery
  • Performing the intended surgical procedure with the right resources and personnel in attendance

Key to moving patients safely and efficiently from the waiting list to the procedure they need is having a digital solution that can do the ‘heavy lifting’ and provide the organisation with the clarity about patient readiness for theatre, theatre availability, resources (and crucially resource conflicts) and post-operative arrangements. Theatreman AQUA has inherited the same base functions that have supported many organisations manage their peri-operative activities.

Scheduling and Optimising Theatre Usage

Variations in productivity between trusts and specialities has been suggested in the past (NHS improvements). Data suggests that late starts, early finishes reduce productivity with missed opportunities to utilise theatres.

Visibility of the next 6 weeks activities is certainly helpful when aiming maximising productivity but having real time session summary views means cases can be arranged at short notice, filling under-utilised theatres and rearranging session lists and re-ordering patients.

Before a patient from the waiting list is booked onto a session in theatreman AQUA, the sessions themselves are configured by the organisation with easy access to session profile configuration, resource, and personnel allocations. Building theatreman users a bird’s eye view of theatre availability over a 6 week period helps to achieve optimal utilisation, essential in moving patients from a waiting list and into a scheduled theatre slot.

Theatreman AQUA has made the task of managing theatre sessions by providing functionality such as block booking sessions, splitting, editing and offering cancelled sessions and so on by doing this in a single front end view.

An interface with the Waiting List

Finally, accessing the waiting list from within theatreman AQUA and being able to perform several actions from that interface is the first important step in managing the backlog. Our users have a view of all patients on the waiting list with an ability drill down into each patient to view their patient episode screen and for example view a completed pre-assessment or start a new one. The interaction our users have with the waiting list and the patient on it is designed to make the task of managing patients waiting for elective surgery as streamlined as possible with minimal clicks.