With 7.7 million patients waiting for treatment in England in August 2023, waiting list validation is a shared priority among NHS trusts – and tackling this issue is no newfound pursuit for Great Western Hospitals (GWH). As of July 2022, GWH faced a significant backlog of non-urgent elective procedures, with over 33,000 patients waiting to be seen for 14 weeks on average - some over a year. In response, GWH started a digital transformation project to reach and engage patients quicker and reduce their growing waiting lists.

Challenge

At its peak, the waiting list for GWH's Dermatology department had grown to over 3,300 patients. The department were already making efforts to combat the issue, but with limited success - booking teams still struggled to mange the large volume of outbound calls to validate patients. 

This growing waiting list, coupled with changes in NHS policy - to validate and prioritise Dermatology patients in support of the NHS Elective Recovery Plan - prompted the search for a more streamlined, automated solution.  

Solution

The first big step for GWH involved the removal of an integration filter, which was limiting access to just those patients who were on the waiting list for six months or less. It was crucial to include patients beyond this waiting period to ensure clinical teams had an up-to-date understanding of all patient information along their recovery pathway, as patients waiting longer than six months were less likely to still require treatment.

Once GWH removed the filter and refined their patient data, DrDoctor started to reduce waiting lists by combining DrDoctor Assessments and Notifications & Reminders capabilities into a custom workflow. GWH could then automate the sending of SMS and email notifications to patients, inviting them to complete their assessment. Patients were given a window of three weeks to complete the assessment - if not complete by then, an automated SMS and email reminder was sent to the patient 10 days before their assessment expired.

In the DrDoctor patient portal, Dermatology patients would securely detail:

• If they still required an appointment (and if not, why).
  
• If they were on any active treatment for their skin condition.
• If they didn't require an appointment, did they wish to be added to a Patient Initiated Follow-Up (PIFU) list, instead of being discharged.

This custom workflow enabled GWH to quickly and accurately validate patients on their waiting lists and allowed stretched booking teams to shift their focus to contacting hard-to-reach patients who failed to complete their digital assessments.

Impact

• Reduced Dermatology patient waiting lists (new and follow-up appointments) by 10%.
• Successfully reached 98% of patients, with SMS reminders increasing response rates from ~48% to 75% among over 3200 recipients. 
• 9% of patients were unaware they were on the waiting list. 
  
• >6% of patients wished to remain on a PIFU pathway.
• 26 days of working time saved for admin teams. 
• 84kg Co2e emissions saved from adopting digital WLV.
  

Estimated Annual Cost Savings:

• £5,645 by digitising the WLV process, compared to paper forms.
• £110,200 from estimated reduction in clinician hours. 

Next steps for GWH

The Trust are now building on the success of the project by deploying the workflow across multiple specialties, with plans to validate thousands of patients through DrDoctor Assessments in 2024 and beyond.