Monitor October 2015
- This report concentrates on potential improvements in the operational management of elective patient pathways within the direct control of NHS providers and identifies a mechanism whereby clinicians and managers can work together to maximise provision of care.
- The report examines ophthalmic and orthopaedic elective care pathways (representing about 30% of elective care expenditure in England) but findings have implications for other specialties.
- The report identifies nine practices for improving productivity in an elective care pathway within a provider, from first specialist input to postoperative inpatient and outpatient care
- Focusing on five of the nine good practices reviewed will realise most of the potential productivity gain in elective care available to NHS hospitals.
- These five practices are:
- stratifying patients by risk and creating low-complexity pathways for lower risk patients
- extending clinical roles to enable lower-grade staff to undertake routine tasks in theatre or outpatients usually performed by consultants
- increasing throughput in theatres by explicitly measuring, communicating and managing the number of procedures per theatre session
- implementing enhanced and rapid recovery practices to reduce length of stay
- providing virtual follow-up for uncomplicated patients.
Appendix B: international case studies - Australia, Europe, Finland and the US.
Appendix C: examples of good practice in the NHS
Appendix D: financial analysis
