The challenge
In 2021, NENC ICB developed a high-level model for supporting the longest waiters for surgery to prepare physically and psychologically for their procedure in response to the COVID-19 pandemic, which further exacerbated existing health inequalities in our most vulnerable communities.
NENC ICB commissioned a team of NECS project managers to establish the governance for the programme and to oversee the implementation of this model across six sites across the region, along with a Central Hub. The programme was funded by £3 million NECS Transformation Fund, and £4.4 million from the Health Inequalities National Funding, a total of £7.4 million investment over three years.
Our response
- Worked with the ICB Programme Management Lead to design and implement a governance structure and PMO to enable successful assurance and escalation and strategic and operational oversight of the programme across NENC ICB.
- Aligned place-based services with a Central Hub (staffed by NECS, managed by elective services team).
- Project managed the development and implementation of Waiting Well services in the six sites / areas.
Techniques and tools:
- Proactive stakeholder mapping and engagement to bring together SME and representatives from across the system, developing excellent relationships and delivering a truly system-wide transformation programme.
- Developed and implemented reporting and assurance processes.
- Delivered effective project management across six Place-based teams.
- Established local project delivery groups to design, plan and implement the high-level model at Place.
- Worked closely and cohesively to deliver at scale change, ensuring consistency was balanced with the nuance and local needs of each place.
- Co-developed services, pathways and clinical interventions.
Outcomes
- October 2022 to January 2024:
- 8266 patients were offered support.
- 2997 patients accepted support.
- All six sites are supporting patients from some of the most socio-economically deprived areas in NENC.
- Four of the six sites have onboarded with the Central Hub since its launch in March 2023.
- Some patients improved to the point they no longer felt they required surgery.
- Patients who would previously have had to have their surgery cancelled / postponed were able to proceed due to the improvement in their HbA1C (blood sugar) control.
- Pathways developed to support patients to address a range of clinical and social barriers to surgery through group, 1:1 and signposting support, including smoking cessation, healthy weight, behavioural change, financial support and other areas as required based on what matters to the individual.
- Patient call logging system and database (K2 – which sits within NECS Business Automation) launched with support from CDT and is now in phase two of development, which aims to capture the entire WW programme.
- Facilitated development and delivery of a Small Grants VCSE Pilot, aligning another 29 VCSE organisations to Waiting Well, with a further investment of £163k into local VCSE Deep End network/ Waiting Well Pilot TAPER2 – funding agreed, project due to launch in June 2024.
- Developed a pathway to deliver bespoke, person-centred support to patients with learning disabilities.