Developing a way forward for elective care post-COVID in an acute hospital

Impacts

Identified that throughput across planned care had fallen to 57% of pre-COVID levels across 20 procedure archetypes
Developed an industry-wide, evidence-based roadmap outlining practical levers to restore and exceed pre-COVID capacity through new best practice protocols
Brought together NHS and Independent Sector (IS) leaders to standardise approaches and improve existing guidance

Opportunity

In the first few months of COVID, members of the Independent Healthcare Providers Network (IHPN) were trying to understand and quantify the COVID related impact on their throughput, and therefore, their finances. This was a particular challenge due to the rapidly changing and sometimes contradictory COVID related safety protocols.

In June 2020, IHPN engaged TN in a novel programme to estimate the operational and financial impact of these protocols on the delivery of planned activity within the Independent Sector.

Approach

To develop insights, we established steering and working groups comprising subject matter experts from both the Independent Sector and the NHS. Through these groups, we:

  • Identified drivers of delays: Synthesised protocols from a wide range of sources and collectively agreed the drivers of delays
  • Developed procedure archetypes: Segmented over 5,000 procedures into 71 groups, and then consolidated these into 20 archetypes across five categories
  • Quantified throughput reduction: Applied relevant delays to each of the 20 procedure archetypes to estimate throughput reduction, along with additional PPE and fixed costs not covered by existing contracts

In order to mitigate the identified throughput reduction and deliver value to patients and the taxpayer, we worked with IHPN to develop a roadmap to recovery, which comprised three levers:

  • A: Identify and agree best practice implementation of protocols
  • B: Improve operational productivity and efficiency to mitigate delay drivers, capacity restrictions and additional costs
  • C: Shift mindsets to realise the full potential of A and B

We built on this programme of work to co-author an article with IHPN in September 2020, which estimated the backlog of patients that had built up due to the reduction in throughput. This included an estimate of the ‘hidden’ demand i.e., from the drop in referrals due to lack of access to GPs. This article goes on to establish, at a high level, a way forward through extending the collaboration between public and private sectors.