Elective recovery

It is imperative, following a significant reduction in elective services during the emergency phases of the pandemic, that elective services recover to pre-pandemic levels.

National priorities reflected in our local plan focus on reducing long waits for elective care diagnostics and admission and on access to services for cancer diagnosis and treatment. However, locally our challenges are mainly seen in staffing levels and retention and the many patients who potentially require treatment but may not have come forward yet.

Unlike some parts of the country, Surrey Heartlands had only a relatively small number of people whose wait time increased over two years during the pandemic. We expect all of these to have received their treatment by July 2022. Our focus then moves to the patients who have been waiting over 18 months and those waiting over a year. Our waiting lists are managed through clinical priority: for example, prioritising cancer patients. However, our plan also incorporates reductions in the number of people waiting for more routine care.

Elective recovery summary

In summary:

  • No one waiting over 2 years by July 2022
  • No one waiting over 18 months by March 2023
  • No one waiting over 1 year by March 2024

Delivery of our elective recovery plan includes several initiatives:

  • Development of a network of Community Diagnostic Centres (a hub and spoke model) 
  • Continued development of the Surrey, Sussex and Frimley Imaging Network 
  • High-volume, low-complexity surgery delivered in designated elective (planned care) sites 
  • Use of digital technology to support care 
  • Development of care models to consolidate attendances, provide flexibility to arrange own follow-up appointments and expand capacity to deliver high-quality care 
  • Delivering more planned care than before the Covid-19 pandemic

Delivering more planned care than before the Covid-19 pandemic

We will focus on:

National 'Must Dos'

  • Patient initiated follow-up
  • Advice an guidance
  • Diagnostics and community diagnostic centres
  • Virtual wards

Local system priorities 

  • Elective care centre
  • Orthopaedic / Musculoskeletal transformation and first contact practitioners
  • Theatre productivity / high volume low complexity
  • Pre-op / waiting well
  • Intra-session utilisation
  • Extended hours

Elective Centre  – Surrey Heartlands has successfully bid for additional Targeted Investment Fund capital to support the development of an elective hub on the Ashford Hospital site. In the first instance, this hub will keep the high-volume low, complex surgery across Ashford and St Peter’s Hospitals and Royal Surrey NHS Foundation Trust.

Digital Integration – Surrey Safe Care - Surrey and Sussex Healthcare Trust already uses a Cerner electronic patient record system. Our other two acute trusts - Ashford and St Peter’s Hospitals and Royal Surrey NHS Foundation Trusts – are introducing a similar Cerner Patient Record system (Surrey Safe Care) between April and June 2022. Surrey and Sussex Healthcare Trust plan to upgrade and align in autumn 2022. Surrey Safe Care will allow clinicians across the trusts to see the full record of their patients, supporting patient care across Surrey Heartlands.

Outpatient transformation – We are building a more personalised approach to follow-up care in hospitals or clinics. We will do this by expanding the uptake of patient-initiated follow-up to all major outpatient specialities, ensuring patients are discharged when relevant clinical pathways have been completed but can ask to be followed up as and when needed. We are also exploring digital opportunities such as remote monitoring, peri-operative tools, waiting list management tools, outpatient appointment portals and artificial intelligence tools.

Virtual Consultations  - Surrey Heartlands delivered 30% of its consultations virtually during the pandemic and plans to maintain this practice across appropriate specialties. Additional infrastructure has been established to support clinicians, including digital solutions to help patient access and redesign clinic structure.

Specialist advice, including advice and guidance – ‘Advice and guidance’ for referrers is already well progressed in Surrey Heartlands, achieved through solid working relationships between clinicians at a local level and support previously provided through Consultant Connect. Advice and guidance delivers positive benefits through reducing referrals, attendances and admissions.