Following the establishment of the elective recovery taskforce – designed to “maximise all capacity available to us” by bringing together voices from across healthcare – the government has published an implementation plan which places focus in key areas, including empowering patients to exercise their right of choice and enabling longer-term system sustainability.
Let’s take a look at the digital work and actions included in the plan.
Right to choice
In this area, the plan emphasises that patients have a right to “choose their provider of consultant-led services at the point of referral”, which “can drive faster treatment times and better outcomes”.
The plan notes that the taskforce identified a number of barriers to empowering patients to exercise right of choice, including perceived complexity with the electronic referral system (e-RS) due to the fact that it displays two menus to choose services from; technological barriers to patients in managing their care pathways; and a lack of reporting data on whether or not patient choice has been consistently offered.
To make improvements in this area, the plan points to the Digital Mutual Aid System (DMAS) – an existing national system which can facilitate mutual aid requests and offers between providers. “NHS England is developing a patient-initiated DMAS that will enable patients to request to move provider,” the plan shares. By October 2023, it is expected that patients who have waited more than 40 weeks without being offered their first outpatient appointment will be able to initiate a transfer request to another provider.
Other improvements include the NHS’s work to roll out patient engagement portals. Once established and linked up with the NHS App, the portals will enable patients to view appointments and request changes. The plan emphasises the ambition to have 90 percent of trusts enabling this functionality by September 2024.
The plan also highlights developments to the e-RS which mean that referrers can now see all potential providers in a single menu and can sort them by waiting times. In line with this, NHSE has rolled out communications to GPs to inform them on the changes to the system and encourage them to offer choice consistently at referral.
Other existing improvements include NHSE’s expansion of the My Planned Care service, to support patients to compare providers in their local areas, including waiting times, via the platform. The plan shares that the NHS is to continue developing waiting time information over 2023 “to improve accuracy, and ensure referring primary care professionals and patients have access to the same information.”
In addition, the government and NHSE have set out planned improvements to the NHS App which are intended to increase choice for patients already on waiting lists and raise awareness of right to choose.
Enabling longer-term sustainability
The taskforce has highlighted the importance of ensuring a sustainable workforce and facilities to provide additional capacity “both now and in the future”.
To support this, NHSE is in the process of developing the NHS Digital Staff Passport, due to go live in December 2023. The passport will “enable a verified virtual record of a doctor’s training and occupational health records” with the aim of reducing the administrative burden of moving between providers.
In addition, NHSE is to build on the experience of community diagnostic centres by “developing a mechanism to track, monitor and evaluate independent sector’s impact on the long-term NHS capacity landscape.”
Delivering on this plan and going further
In order to “maintain momentum” on the work put in motion by the taskforce, the new plan shares that “material improvements have been introduced in how data and evaluation are used across the NHS and independent sector to monitor specific changes in independent sector provider use, as well as the outcomes of care”.
This includes NHSE publishing regular data on independent sector use as part of a single data set from July 2023, which will show the independent sector’s contribution to tackling the backlog and “help to ensure that independent sector activity is additional rather than displaced NHS activity”.
The plan also notes that NHSE is internally tracking year-on-year changes in activity across all specialisms, to “prioritise the commissioning and delivery of a more diverse range of services from July 2023”.
The implementation plan can be found in full here.
At the start of this year, we shared a special report exploring tackling the elective care backlog through case studies and thought leadership. In particular, we heard from James Rawlinson, CIO at South Yorkshire and Bassetlaw ICS and director of informatics at The Rotherham NHS Foundation Trust, along with Royal Cornwall Hospitals NHS Trust transformation lead Helen Williams, for a discussion on the work that they have been doing to tackle their waiting lists.
We also published a special report into patient portals along with an exploration of digital leader perspectives on the lessons learned and impacts around portals.