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This report outlines the progress made on the 18-Week Referral to Treatment (RTT) wait times in spinal surgery as of December 2008. It details current patient tracking statistics, including backlogs for admitted and non-admitted patients, and introduces a new action plan for addressing these issues. Key strategies include implementing new access policies, enhancing training for administrative staff, and increasing surgical capacity through recruitment. The report also discusses potential improvements and timelines for achieving target wait times within spinal surgery services.
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18 week RTT – Spinal Surgery Trust Board December 2008
18 week RTT: Progress on unknown clock starts Numbers of unknown clock starts on patient tracking lists at 17 December 245 non admitted 8% 45 admitted 3% 290 total 6.5%
Reducing Admitted Backlog – Current position for patients already breached 18 weeks Total 255 Spinal 148 Non spinal 107 • Ready reckoner of weekly expected clock stops - 144 • Reasonable weekly ready reckoner for spinal - 20 • Spinal backlog = 7 weeks’ work • Non spinal weekly ready reckoner - 124 • Non-spinal backlog = less than 1 week’s work
Reducing Non-admitted backlog Total 521 Spinal 269 Non spinal 252 RNOH weekly ready reckoner is 178 Backlog = 3 weeks’ work Spinal ready reckoner – to be devised
Spinal Surgery Action Plan General • Implement new access policy and guidance: commenced • Train secretaries: booked • Scope impact of data cleansing inpatient waiting list: complete December • Implement waiting list management changes: January • Invite DH team to work with surgeons in clinic: January • Complete recruitment for additional deformity surgeons January/February • Business cases for additional MDT staff and recruitment: staff in post March onwards • Establish potential for increased tolerance: complete March • Continue to work on implementing criteria, sharing referrals etc: ongoing • Demand/capacity work to establish referral increase and pattern: December, share with surgeons in January • Increase OPD and theatre capacity – project plans in place
Spinal Surgery Action Plan Non-admitted backlog • Devise weekly/monthly non-admitted spinal ready reckoner and assess impact of any new appointments on backlog: mid January • Reduce wait for scan and report to 2 weeks: end March • Implement direct booking for scan and follow up: February Admitted backlog • In contact with Berck Plage: outcome January • Negotiation in progress with independent sector: outcome January • Transfers to NOC (low back): outcome end December • Continue with additional sessions to maintain 26 weeks
Potential timescale for achieving 18 weeks in spinal surgery • Potential clock stops from 3 additional surgeons – 6 per week • Backlog cleared in 25 weeks, assuming no growth in backlog • Therefore initial target date – December 2009 if surgeons join from June on • This date will come forward if additional capacity is sourced successfully
Foundation Trust Impact • Extenuating circumstances application to Healthcare Commission with DH support • Spinal Task Force supporting national strategy – ongoing • Specialist commissioning approach from DH/NHS London for paediatric spinal deformity • Lessons from Birmingham
