Plastic Surgery in the East of England


Number of appointments

Number of patients seen

99.03 %

Pleased with initiative

Pleased with initiative

98.70 %

Happy with care

Happy with Care


Following the pandemic and ever growing demand, a trust found itself with an ever- increasing waiting list of Dermatology and suspected skin cancer patients, requiring rapid access to treatment; caused by excessive demand, capacity shortfalls and exacerbated by the impact of COVID on elective care. The trust recognised a need to look for an organisation which could implement cost-effective insourcing solutions and offer a high level of patient care all while eliminating long waiting lists and getting the Dermatology Department back on track, at pace. They chose to partner with The Surgical Consortium (TSC) which offered a wraparound, insourcing service with exceptional quality, expertise, reputation and ability to offer bespoke, agile solutions. In November 2022, TSC were tasked by the plastic surgery department to assist with the backlog of long waiters and urgent 2ww referrals.

The Challenge

The Plastic Surgery department had tasked TSC with eliminating long waiters as well as increasing capacity for 2ww and urgent skin cancer referral patients that could not be accommodated in the week. TSC took full ownership of the whole patient pathway from auto-triaging patients according to procedure required, through to operating on those who required surgery and post-operative dressing clinic and follow up. TSC also managed the histology and the necessary ongoing treatment required including referral to MDT meetings, for which TSC always had a representative or two.

The Approach

TSC implemented technology and refined pathways where possible to allow for high volume parallel theatre lists. Auto-triaging of patients according to the procedure required using natural language processing allowed surgical time to be assigned for each patient and maximise efficiency of the lists as well as working on skillset of the assigned surgeon. As always, TSC adopt a hybrid patient led approach to booking appointments, through bot-assisted theatre appointments booking system combined with telephone calls to patients, TSC ensured the list and operating time was fully utilised whilst supplying the full theatre team for all theatres and dedicated co-ordinator. Theatres were comprised of both reconstructive cases and non- reconstructive cases.

As part of the full wrap-around care TSC always provide a plastics dressing clinic in subsequent weekends with no limit on the number of times a patient can attend. In addition to the procedure, TSC consultants also take full ownership of the histology results. Results are available for remote outcoming by the operating surgeon to ensure a rapid response to any histology result including MDT for which The Surgical Consortiumguaranteed minimum of one or two representatives. This wrap around care carried over from MDT in the form of TSC absorbing any patients requiring secondary procedures. All results are conveyed automatically to the patients and GP.


The success of the project was attributed to a number of key factors:

  • Dedicated Clinical Lead for Plastic Surgery and a dedicated co-ordinator on the day. The clinical lead and head of department allows for full oversight of pathways and governance. This is complemented by fellow senior surgeons, senior scrub nurses used to working across high volume lists.

  • Lean, high volume parallel theatre lists resulting in 2235 appointments

  • TSC led plastics dressing clinic for post- operative patients, with no limit on the number of consultations for patients.

  • Technology assisted, patient led approach to bookings to reduce DNA rate and improve the experience for patients.

  • Regular governance meetings including Morbidity and mortality for full ownership of these patients

  • Utilising remote reviewing of histology allowed us to expedite patient pathways of those needing ongoing care and surgery or to be discharged.