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Like many NHS providers, our client had significant challenges with managing its Cancer waiting-list, exasperated largely by the impact of Covid-19. Coupled with workforce issues, the Trust’s Cancer wait-times were increasing daily and they were struggling to tackle the growing backlog. At the point of engagement, over 3,000 cancer patients were being tracked every week and the data was showing over 600 waiting over 63 days. This posed a significant risk to the patients waiting for treatment and those yet to get a full diagnosis, so it was critical the Trust put in measures for rapid and effective recovery. Understandably the Trust became one of the worst performing in the Country for managing Cancer wait-times and there was a lot of external scrutiny at both a regional and national level. As such they set themselves a target to reduce the backlog by 40% by the end of the year.
Following Xylem being chosen as the preferred partner to assist the recovery of the Cancer waiting-list backlog and ultimately improve the Trust’s overall performance, our Associate Partner quickly embedded into the organisation and set about delivering a rapid diagnostic of Cancer services to establish what the priorities needed to be. This included:
One of the key issues driving the backlog was the fact that the Cancer Services department was significantly below establishment and the team did not have the capacity to look at the whole PTL all the time so were moving from specialty to specialty depending on where the numbers were peaking. As such the focus was solely on the backlog which was proving ineffective. Some of the other key findings from the review included:
Following this it was identified that a validation and data quality exercise would need to be carried out at scale in order to determine if the backlog was accurate and effectively recover the Trust’s position.
Having supported several NHS validation and data quality projects previously, we were able to quickly mobilise a team of data quality specialists and trackers with specialist experience of Cancer pathways. We also ensured the team had experience of using the systems used by our client ensuring training would be minimal and the team could hit the ground running.
Using a staggered approach, we deployed a team of Cancer trackers under the supervision of a Team Lead and the direction of our lead Associate Partner who was already on the ground.
In collaboration with the Trust, Xylem’s team first carried out an initial discovery phase which identified the gaps, opportunities to improve process as well as agree a way forward to tackle the growing backlog.
Our team first reviewed the PTL by specialty to understand the challenges and bottlenecks experienced by the various services. Through this we quickly identified that staff were being measured on the number of patients that they tracked each day which led to several people tracking the same patient just to keep up activity. This often resulted in patients having numerous tracking updates with no real progress along their patient journey.
Some of the steps for improvement we took over the next 8 weeks included:
