Buckinghamshire Healthcare NHS Trust is streamlining surgical pathways and tackling waiting lists with an innovative digital population health dashboard that combines its surgical waiting lists with the Buckinghamshire Shared Care Record.

Believed to be the first example of this kind of digital integration in the UK, the dashboard was developed and piloted by Buckinghamshire Healthcare NHS Trust to tackle waiting lists in the aftermath of the pandemic.

The work has been in collaboration with Graphnet Health, one of the UK’s best-known providers of shared care records and population health management solutions.

The results of the project have included:

  • Faster and easier identification of high-risk surgical patients, enabling clinicians to provide more accurate, targeted support pre-surgery, reducing the likelihood of cancellations.
  • Identification of low-risk patients on current waiting lists to improve the efficiency of pre-assessment clinics (before surgery) and reduce the need to attend preoperative clinics.
  • Identification of patients suitable for operation in elective surgical hubs in line with NHS England’s ‘high volume low complexity’ (HVLC) strategy, reducing waiting times for some of the most common procedures such as cataract surgeries and hip replacements.
  • Fast-tracking of low-risk patients when there are short-notice gaps in theatre schedules.

Since the dashboard launched in 2023, Buckinghamshire has seen time and resource savings, improved outcomes, and a better experience for patients, including those with conditions that could pose a risk during surgery.

The incorporation of primary care data allows clinicians to identify patients on waiting lists who have chronic conditions such as hypertension, diabetes or obesity, and those with co-morbidities.

It is then possible to easily identify patients who need information on how to prepare themselves while waiting for surgery. It is also supporting surgical teams to understand the co-morbidity implications for theatre and helping them book the right patients at the right time. 

Working with GPs

Many of the local GP practices are also supporting patients to make lifestyle changes, such as reducing alcohol and smoking, and increasing exercise, which will better prepare them for surgery, and reduce the likelihood of cancellations.

Dr Caroline Pritchard, consultant anesthetist and perioperative service clinical lead for Buckinghamshire Healthcare NHS Trust, said: “This exciting and powerful digital innovation has enabled us to remap our peri-operative pathway, benefiting our patients and boosting recovery of our elective operating lists.

“The time savings have been extremely valuable. For example, previously, all pre-operative patients would have filled a 45-minute clinic appointment. Now, manual triaging by a senior nurse has been completely removed, and 20 out of every 100 patients will avoid a pre-operative assessment (POA) completely.

“This will save a minimum of 15-hours of nursing time, meaning they can spend more meaningful time with their patients, along with the cost of previously associated unnecessary investigations.

“We are also working closer than ever with our primary care partners, particularly when it comes to supporting patients before surgery. More than 35% of patients have reported a positive behavioural or lifestyle change in preparedness for surgery, following contact from their local GP.”

Candidate lists for cancellations are helping fill cancelled slots. The dashboard automatically stratifies patients, which enables the instant identification of low-risk patients that can be booked in to available surgical appointments straightaway, filling cancelled slots immediately.

The next step for Buckinghamshire Healthcare NHS Trust is to use the dashboard to support the management of other waiting lists, including those for outpatient services, diagnostic procedures and beyond.

Back in 2018 we reported health and social care organisations across Buckinghamshire, including Buckingham NHS FT, selected Graphnet to provide a county-wide shared care record for 530,000 residents.