Pain Management in the South East of England

850

Number of appointments

Number of patients seen

100 %

Pleased with initiative

Pleased with initiative

97.40 %

Happy with care

Happy with care

Background

In an integrated acute and community Trust serving 800,000 residents, they are the largest NHS organisation in the East of England.

In November 2023 The Surgical Consortium (TSC) were tasked by the Pain department to assist in the backlog of
500 patients awaiting first outpatient appointments, re-triaging via virtual clinic and interventions as required. The Surgical Consortium were took full ownership of the pathway from booking, to radiological investigations through to interventions, staffing and post-op reporting

The Challenge

In the Pain Department, we had a goal to address the needs of 500 patients by March 2024, aiming to tackle wait times exceeding 78 weeks as well as creating space below this. Taking comprehensive ownership of the entire patient journey from the moment we received the Patient Tracking List (PTL), our responsibilities encompassed:

- Validating and triaging the complete PTL
- Overseeing all administrative tasks and scheduling for clinics and interventions
- Conducting initial patient assessments during their first outpatient visits, coordinating radiological as needed as well as reviewing the results
- Administering necessary interventions, for those requiring them with the full theatre team supplied by The Surgical Consortium for high volume list of 20+ patients a day

- Maintaining accurate and current records within the Trust systems

The Approach

Swiftly validating the PTL through technology and human outreach, we subsequently moved onto front loading clinics and radiological requirements. With clinic numbers over the weekend reaching 60 patients, a noticeable change in patients awaiting first outpatients was witnessed. 

Intervention lists, with full teams supplied by The Surgical Consortium, followed. With streamlined and lean approach to these lists, day case lists of one theatre allowed us to see 40+ patients in a weekend. 

Our team conducted all administrative duties through booking, and continued to virtually consult those pre and post intervention to good effect

Summary

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

  • Dedicated clinical lead for Pain, accustomed to high volume intervention lists and taking full ownership of the patient cohort. Complimented by an experienced theatre team, all well drilled for lean and high volume lists, allowed 40+ day case patients in a theatre across the weekend. 

  • Running effective lean clinics and theatres in parallel 

  • Working alongside the local radiology department and blood laboratory to allow for an efficient and accelerated work-up.

  • Implementing a technology and patient led approach with bookings and patient outcomes. Virtual consultations only enhanced the acceleration and effectiveness of the pre-intervention phase

  • Utilising remote reviewing of radiological investigations allowed us to expedite patient pathways of those needing intervention or to be discharged.

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