Digital pre-op assessment at Chelsea and Westminster supports waitlist reduction

NHS England has shared a case study on digital preoperative assessment (POA) triage at Chelsea and Westminster Hospital NHS Foundation Trust, reporting key takeaways including a waitlist reduction of 17,003 patients and an 8 percent improvement in theatre utilisation.

Building upon increased demand for POA in the wake of the COVID-19 pandemic and identified shortcomings in the existing process which can result in delays and surgery cancellations, the trust sought to design and deploy their own solution capable of integration with other elements of the patient surgical pathway on the Care Coordination Solution (CCS).

Developed through collaboration with Palantir and Isla Care, the solution automatically sends patients a digital health questionnaire, covering whether patients still require surgery, 15 health-related questions to help with assessment, and patient availability at short notice. Patients answering ‘no’ to all 15 health-related questions, aged 18-64 and with a BMI of less than 40 are placed on the list of those not requiring POA.

According to the case study, one of the main benefits of the new digital triage is that it allows those with no complex medical history and those having less-complex procedures to bypass the POA step altogether, freeing up resources and appointments for those who need them.

Chelsea and Westminster found that 86 percent of patients completed the questionnaire within six days, and results indicate that the digital system has led to savings in time and efficiency through 180 patients per month not requiring POA. Other impacts include a 57 percent reduction in POA-related on-the-day theatre cancellations, and prioritisation of 96 percent of all patients on surgical pathways, including the carrying out of a clinical harm review.  In addition, the digital POA system has helped the trust in identifying 222 patients without NHS numbers.

Key learnings from the trust include how engagement with stakeholders and experienced clinicians is “crucial”, with an internal project manager called a “critical conduit between the supplier and the clinical teams.” The trust says that the solution has strengthened communication between POA teams and the different departments, and supports a clear audit trail.