NHS’s £160 million ‘accelerator sites’ to tackle waiting lists

The NHS has today announced a £160 million initiative to tackle waiting lists and develop a blueprint for elective recovery as early reports show the health service is recovering faster after the second wave of the coronavirus pandemic.

Indicators suggest operations and other elective activity were already at four fifths of pre-pandemic levels in April, well ahead of the 70% threshold set out in official guidance.

That was despite NHS staff still dealing with thousands of COVID patients, having to take additional steps such as infection control measures to keep patients safe and rolling out the largest vaccination programme in health service history.

NHS England is now seeking to accelerate the recovery by trialling new ways of working in a dozen areas and five specialist children’s hospitals.

The ‘elective accelerators’ will each receive a share of £160 million along with additional support to implement and evaluate innovative ways to increase the number of elective operations they deliver.

Over the next three months tens of thousands of patients in those areas are set to benefit from initiatives that include a high-volume cataract service, one stop testing facilities, greater access to specialist advice for GPs and pop-up clinics so patients can be seen and discharged closer to home.

Virtual wards and home assessments, 3D eye scanners, at-home antibiotic kits, ‘pre-hab’ for patients about to undergo surgery, AI in GP surgeries and ‘Super Saturday’ clinics – where multi-disciplinary teams come together at the weekend to offer more specialist appointments – will also be trialled.

The aim is to exceed the same number of tests and treatments as they did before the pandemic and develop a blueprint for elective recovery to enable hospitals to go further and faster.

Amanda Pritchard, NHS Chief Operating Officer, said: “Treating around 400,000 COVID patients over the past year has inevitably had a knock-on effect on non-urgent care, but our incredible staff still managed to perform more than two million operations and other treatments in the first two months of this year when the hospitals were at their busiest with COVID patients.

“With COVID cases in hospitals now significantly reducing thanks to the extraordinary success of the NHS vaccination programme, our focus is now on rapidly recovering routine services. Early figures show local teams are already well ahead of schedule, but we want to go further, faster which is why we are investing £160 million to find new ways to tackle waiting lists.

“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.”

Thanks to its agile response to COVID-19, and the hard work of staff to keep non-COVID services going, the NHS has been able to deliver more than 12 million planned operations and procedures, and over 19 million key diagnostic tests, since the beginning of the pandemic.

Despite caring for a far greater number of COVID patients in the second peak, hospitals also maintained high levels of planned care compared to the previous year, and average waiting times for planned surgery have fallen by almost 40% from July 2020.

NHS staff completed almost two million operations and other elective care in the first two months of this year while also providing hospital treatment for almost 140,000 COVID patients, around two in five of everyone who has required hospital care for the virus since it first hit.

The number of treatments delivered in January and February was over 800,000 or 70% higher than during the height of the first wave.

The emerging data suggests services have already bounced back quicker than they did over last summer, when it took until September to get back to 80% of usual levels of treatment.

Thanks to the success of the world-leading vaccine programme, the NHS is now supporting all local health systems in England to treat as many patients whose care was unavoidably disrupted by the pandemic as quickly as possible.

GPs, specialists and their teams are focusing on those in greatest clinical need and who have been waiting longest, with an additional £1bn funding already announced, available to trusts.

Other interventions being supported to help NHS teams go further and faster on recovering elective services include:

• North London Partners ICS will extend NHS operating hours, as well as using the independent sector, and offer patients care in newly-designed surgical hubs.
• Devon ICS is repurposing the Exeter Nightingale to perform diagnostic tests, and patients in the south west will also benefit from the extension of virtual wards so patients can receive medical support from the comfort of their home, freeing up beds in the process so more patients can be admitted to receive elective care.
• Lancashire and South Cumbria ICS is using AI to prioritise and identify the right level of care and support needed for patients on the waiting list.

Professor Neil Mortensen, President of the Royal College of Surgeons of England said: “We welcome today’s announcement of funding for accelerator sites to explore and test new ways to get the elective backlog down. It will take both innovation and collaboration to reduce the huge waiting list that has built up over the last year.  2020 was incredibly challenging for the NHS, but in the midst of the pressure, staff and hospitals came up with new solutions to keep urgent surgery going. Operations were scheduled at weekends, ‘surgical hubs’ were created and groups of hospitals worked together providing ‘mutual aid’ to each other. Embedding the learnings and innovation is key to the future sustainability of surgical services.”

Professor Helen Stokes-Lampard, Chair of the Academy of Medical Royal Colleges said: “The pandemic has been truly awful for all of us. But as the pressure begins to ease and we start to build back our NHS we need to capture some of the good that came out of the last 12 months – be that through better use of technology, streamlined appointment booking, more efficient ways of working – the list is almost endless. This investment is incredibly welcome and will be very well received, not least because it allows our brilliant staff to map out a way forward with better systems and services that will genuinely improve the quality of care and make life easier for staff.”

Neil Tester, Director of The Richmond Group of national health and care charities, said: “Today’s announcement recognises the real need for creativity and innovation in tackling the elective care backlog. Our member charities are supporting huge numbers of people living with pain, loss of mobility and emotional distress as they wait for essential operations, so we know how crucial getting on top of this issue will be. NHS staff have been working hard to make the current improvements, and now is the right time to trial these new approaches to getting the right help to more people. While the NHS learns from these accelerator site trials, local leaders across the NHS need to make sure patients waiting for operations are kept informed and given the right support, including the help that the voluntary sector can provide.”

Rachel Power, Chief Executive of the Patients Association, said: “The lengthening of waiting times due to COVID-19 has been well publicised, and patients are anxious about what this will mean for them. This worry comes on top of the impact of having to live for longer with the pain or discomfort of their condition, and for many is compounded by having had multiple appointments postponed or cancelled. Steps to accelerate the recovery of elective treatment are therefore very welcome – the importance of treatment being timely, to ensure the best possible outcomes, is well recognised. Effective communication with patients at this critical juncture is also essential, and we have been pleased to work with NHS England on developing principles for effective communication with patients about their elective treatment.”

Dr Rebecca Steinfeld, Head of Policy at National Voices, said: “At National Voices, we hear from our members, 170 voluntary and community groups, about the main concerns people living with ill health, disability or impairment have. People’s experiences of delays and cancellations have been a big concern throughout the pandemic, and the lengthening waits for elective treatments are just the tip of the iceberg of wider unmet need. It is paramount that we find better ways of addressing these needs. More of the same will not help people and the NHS recover quickly enough. So we welcome the NHS’s commitment of £160 million for innovations at Accelerator Sites and we also need to find innovative ways of working across organisational and sector boundaries to better support people whilst they wait and to get their problems addressed in the best way possible. We are pleased to be working with NHS England, the professions and patient groups to help with this innovation.”

Chris McCann, Director of Communications, Insight and Campaigns at Healthwatch, said: “With the NHS facing a number of major challenges, including a large backlog of non-COVID-19 care, this funding to tackle hospital waiting lists is very much welcome. We know that over the last year people generally understood why they might have had their appointments postponed as they wanted to play their part in these difficult times. As we move out of the pandemic, the investment into innovation and emphasis on efficiency needs to be coupled with accurate, accessible and personalised communication to those affected. Patients on waiting lists need to be kept informed about next steps for their treatment or care. Additionally, people should know what interim support is available to them and how to access it, especially when it comes to issues such as pain management. Those affected also need to be informed where they are on a waiting list so they have confidence they haven’t been forgotten.”