Dave King is currently the Directorate Manager – Dermatology, Diabetes, Endocrinology & Rheumatology at St Helens & Knowsley Hospital NHS Trust. He has worked closely with Inform People in the development of the NHS tool ‘Thrive’ which will be used to monitor room and equipment usage and will supply the NHS with valuable measurable data to make crucial decisions. Writing a guest piece for us today, here are Dave’s thoughts on the current state of endoscopy departments.
Across all branches of the NHS, there’s a demand to improve productivity and efficiency without adding extra financial strain. We want to see more patients, improve facilities, and perform more procedures in the most cost-effective ways. One department that’s particularly feeling the pressure is endoscopy.
Endoscopy is a diagnostic service that involves the use of cameras. It identifies upper and lower gastrointestinal issues, including the diagnosis of cancer. There’s a range of procedures carried out within endoscopy departments. These include gastrointestinal endoscopy, bronchoscopy, and cystoscopy. But where does the pressure come from?
Endoscopy services in England are currently under increasing pressure. They must deliver the 62-day cancer standard between urgent GP referral and first definitive treatment. All while also meeting the 14-day target for patients to see a specialist after a referral for suspected cancer.
Predicted growth of endoscopy procedures is at 6.5% per annum. There may also a further rise following the introduction of the Fecal immunochemical test (FIT). An alternative to the current fecal occult blood test (FOBT) – which invites adults aged 60-74 for screenings – this new test has higher sensitivity. Because of this, there’s an expectation this will result in more positive tests and increased invites for colonoscopies.
This increasing demand places greater importance and emphasis on efficiency and productivity. There’s also a desire to increase this activity at no extra cost. This is a driving force behind both the operational and financial management of trusts throughout the UK.
A typical tariff for a colonoscopy is around £400. Just one extra colonoscopy per day is £2,800 per week and almost £150,000 per year. Not to mention the potential for extra procedures to take place across many rooms. To give some perspective, these extra costs would fund almost four band 5 nurses.
The best-case scenario is for a trust to accommodate extra capacity with no further investment. This will mean an increase in productivity and efficiency that pleases both board and financial members alike.
What can we do?
Of course, the question is how can we help this situation? The first step – and arguably the most important – is to understand how efficiently you are operating right now. How can you know how and where to improve operation if you don’t know where you’re currently at?
Before increasing productivity, you need a baseline. Luckily, endoscopy services lend themselves well to drawing this baseline. The service is high volume, scheduled, and easily recorded.
Endoscopy procedures are carried out in theatres or procedure rooms. And staff are assigned to these rooms in lists. The industry even has recommended units of time for different procedures. These timings are not standardised or mandated, but offered as guidance by the Joint Advisory Group of which endoscopy units seek annual accreditation from.
When comparing room productivity, it’s important to compare like for like. Procedures and rooms should be assigned based on the timing of each procedure, as opposed to the number of procedures taking place. Otherwise, you could have the same amount of procedures booked for neighbouring procedure rooms, yet one takes twice as long as the other. This would mean one unit is being less efficient and drawing less income. It’s important you find a way to capture this information accurately and incorporate it into your productivity.
Improving productivity and efficiency
With agreed standardisations, you can capture and track daily activity. From here, you can turn this data into productivity outputs or metrics. Using this, try to recognise areas for potential improvement. Increasing productivity and efficiency will need both management and staff engagement.
The time between patients or procedures is a simple yet significant way of increasing productivity. The aim is to reduce these gaps to a minimum and make time for extra patients. This would create capacity which also increases income. A tool that records unused rooms and staff free time would be ideal for improving productivity.
To keep up with demand and potential growth, it’s important endoscopy departments are productive and efficient. Under pressure to free up more time and resources, without extra financial burden, effective time-management has never been more essential.Inform People works with NHS departments to ensure efficiency and productivity. Our platform makes appointment and room booking simple and improves staff communication. It can also create task lists for staff that are monitorable by senior management to ensure completion and efficiency. If you want to find out more information, visit our website here. Or get in touch with us on 0161 713 4104.