We delivered a wave of rapid improvement challenges in elective care specialties across the North Region.

Background
In response to the continued operational pressures in elective care and following the success of the national 100-day challenges, NHS England commissioned MLCSU’s Improvement Unit to deliver a wave of specialty-based rapid improvement challenges across the North Region.

Action
The Improvement Unit supported eight healthcare sites/systems to utilise the 100-Day Challenge methodology to drive rapid improvement in specific elective care specialities. We did this by:

• Providing hands-on coaching and facilitation support to each site during the development and delivery phases, bringing leaders and frontline staff together to test ideas
• Facilitating a series of local and regional collaborative events to guide sites through tools to help them identify, develop, test and monitor improvements
• Providing dedicated ongoing coaching support to local site leads to ensure the progress and success of the activities
• Supporting the development and delivery of local sustainability plans for each initiative to ensure improvements
• Programme evaluation, including training and support for the development of case studies and social media materials for local sites, impact analysis and production of a final report.

The Improvement Unit offered additional project management support, coaching and facilitation where it was required and adopted a collaborative approach to all events; using practical workshops to support localities to achieve their goals.

Impact

• One system looking at the spinal MSK pathway saw Physio First referrals increase threefold in pilot practices, leading to fewer referrals to secondary care
• Paediatric Ophthalmology Did Not Attend rates reduced by 4 per cent with follow-up DNA rate down by 9.1 per cent in one month with one pilot trust
• The same trust also successfully trialled a Virtual Glaucoma Clinic with 41 per cent of suspected glaucoma patients discharged back into the community
• A trust working on ‘cold’ site utilisation reported no patient cancellations, improved patient experience, improved referral to treatment (RTT) performance and cost avoidance of £226,800 as a result of transferring more elective care activity to the cold site
• Another trust saved 15.66 bed days in one month as a result of a successful move for urology patients undergoing trial without catheter in an outpatient setting, another 25 patients (in one week) had their pre-op via telephone on the same day as being listed for surgery, reducing gaps in theatre lists and improving patient experience.

“It has been great to see the impact this approach has had. It has acted as a catalyst to other larger change programmes.” 
“Great change approach; spread & adoption at scale.”
Feedback from evaluation survey