How to tackle the NHS backlog - waiting list initiatives
Dr Maryam Tariq,
Business Development Strategist
It goes without saying that the NHS has gone above and beyond the call of duty since the outbreak of Covid-19. Healthcare professionals have worked non-stop to fight the virus whilst continuing to operate as a nationwide service. Yet despite best efforts to maintain emergency procedures, the ongoing impact of the pandemic has left a devastating backlog of patient care.
The waitlist for non-urgent NHS treatment totalled 4.52 million people at the end of December 2020 - the largest backlog in 12 years - and the number is rapidly increasing. With understaffing and overworked NHS employees to consider, how then, can we support the healthcare system to overcome this urgent problem in a fair and safe way
Here, we share how a realistic solution to this demand vs supply challenge lies with a better allocation of existing resources through real-time workforce management.
The NHS backlog is still out of proportion
Nothing could have prepared the NHS for the scale of patient care required in 2020. Wards and services were repurposed, staff were diverted and retirees returned to the frontline to treat nearly a quarter of a million hospitalised coronavirus patients across the country. On top of absences, social distancing and isolation measures, this saw unprecedented disruption to elective activity.
Whilst the majority of urgent care was maintained, the number of incomplete patient pathways for low priority procedures has reached a high of nearly six million people with a delay in GP referrals and diagnostic treatment - 224,000 of which have been waiting over a year, compared to 1,500 people in 2019.
The situation is deeply concerning for NHS trust leaders who understand the mammoth task ahead of them.
“Trust leaders are deeply worried about the size of waiting lists, not just for operations and diagnostic testing but for all types of care including mental health services,” says Saffron Cordery, Deputy Chief Executive of NHS Providers.
“Despite how quickly trusts are working to deliver for all patients, there are signs that tackling the backlog could take between three to five years on current trajectories.”
The problem is due to the extensive size of demand compared to the current supply of both workforce capacity and NHS facilities. Building or procuring additional theatres, clinics and equipment might be a consideration, however, this is not an immediate solution and certainly won’t be able to accommodate for the scale of the backlog. Equally problematic is the recruitment of new healthcare workers - conjuring a bigger workforce out of thin air is simply impossible, even with a solid talent acquisition strategy.
More must therefore be done to tackle this pressing issue and gain back control of the NHS waitlist.
A multifactorial solution must involve better allocation of our existing resources
Without the unrealistic option of considerably increasing manpower and facilities the only viable solution is to better optimise how current resources are allocated. This doesn’t mean asking more of already overworked NHS employees. In fact it does the opposite.
“It’s time to marry real-time demand for services with staff scheduling”
- Dr Nicholas Andreou Locum’s Nest Co-Founder
Through advanced healthcare technology such as the Locum’s Nest staff management solution, healthcare workers can instead be better allocated to where the greatest need is, hence supply meeting demand.Real-time patient pathways and demand for services are fed into the software to generate shifts and rosters that can be picked up and covered immediately. Even at a micro-level, staff can be rapidly deployed to wards, clinics and theatres at any given time without the need for human intervention. No matter how small or last-minute, any increase in demand is met - meaning the backlog doesn’t get bigger and NHS waiting lists get cleared faster.
The Digital Collaborative Bank (DCB) is the largest and most mature collaborative staff bank for medics, sharing pools of contingent staff across 10 NHS Trusts to accelerate workforce capacity. By working openly and collaboratively, the average Trust has a 5-10% better fill rate, saving the NHS millions in time and financial savings but, more importantly, resulting in increased workforce supply and thus improved patient care..
This was imperative during the height of the pandemic where a bank-only shift fill rate of 91% was achieved across all participatingTrusts compared to the national average of 24%.
The DCB is further strengthened by Locum’s Nest Rota and our flagship solution, Match, which combine to offer automatic optimised e-rosters that support a better work-life balance for NHS employees. Organisations can match shifts to healthcare professionals in seconds, whilst factoring in their preferences and availability. Easy shift-swapping is also enabled to better improve flexible working within the NHS. This provides more choice for staff who have not only worked tirelessly during the pandemic but also throughout the vaccination programme.
Further resources
NHS England recently revealed a £160 million initiative in response to the record waiting lists. Over the next three months, various trial areas will evaluate how innovation in technology increases the number of elective services delivered.
Schemes will include 3D eye scanners, one stop testing facilities, at-home antibiotic kits, virtual wards and ‘pre-hab’ for patients undergoing surgery. ‘Super Saturday’ clinics will also aim to bring down waiting times with specialist appointments whilst AI technology will be used to determine which patients need treatment first.
Amanda Pritchard, NHS Chief Operating Officer, said “the additional support announced today will help us create a blueprint for continuing that progress over summer and beyond, in a way that doesn’t heap extra pressure on staff, so that as many people as possible benefit from the world-class care the NHS provides.”
Other solutions include a ‘record, reward, renew’ approach to building an effective, immediate-term workforce strategy that supports struggling staff, retains those considering leaving and attracts new people to join the NHS.
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If you’d like to find out more about Locum’s Nest and our mission to solve the NHS staffing crisis, please get in touch with Dr Ahmed Shahrabani on ahmed@locumsnest.co.uk.