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Elective Care is in the spotlight. The Elective Reform Plan, published earlier this month, sets out a whole system approach to transform the experience of elective care for millions of people. The key elements of the plan focus on empowering patients; reforming delivery; delivering care in the right place; and aligning funding, performance oversight and delivery standards.

The plan has serious ambitions. Within the first year, there is a commitment to delivering an extra 2 million appointments (equivalent to 40,000 per week) and for 65% of patients to be treated within 18 weeks.

We understand both the scale of the challenge, and how to help.

As part of the People Powered Results team at Nesta, members of our Innovation Team previously ran the Elective Care Development Collaborative in partnership with NHS England. This programme saw widespread change in elective care systems across the country including:

  • New ways of providing specialist advice and guidance to GPs and patients. Across a number of specialties, there was a 25 per cent increase in advice and guidance requests, which helped people to access specialist support earlier.
  • A new process for screening patients with diagnosed or suspected cataracts contributed towards the percentage of people treated, as demonstrated by a referral rate rising from 57 per cent to 95 per cent in one area.
  • Reduced RTTs from 20 weeks to 13 weeks for glaucoma referrals through a nurse-led clinic[1]

Combining on-the-ground testing in systems across the country, alongside input from local and national sponsors, allowed us to demonstrate the value of adopting a combination of top-down and bottom-up approaches to policy change and implementation.

Our expertise is in rapid innovation, and we understand how change at this scale needs support to be developed and owned.

This can be broken down into four key areas.

  1. Seeing the big picture across a system. The complexity of pathways makes it nigh on impossible for any single person, team, or part of the system to have a view of the whole. Bringing together patients and practitioners from across systems to explore the current context and identify challenges and opportunities, can help to build a shared understanding of where and how new ways of working could make the biggest difference. Working together on shared challenges can also help to build stronger relationships across the system.
  2. Aiming big but starting small. Whole system transformation is daunting for most people and often seen as beyond any individual’s remit. Supporting people to identify opportunities to start working differently, from where they are, can help to ignite change, hugely amplify learning and lead to scalable interventions further down the line.
  3. Focus on building connections not barriers. Our highly pressured and fragmented health and care systems have (understandably) come to rely on transactional, rather than relational ways of working. Whilst we know siloes are hugely problematic, they persist and are often amplified during significant times of pressure. However, the opposite is often what’s needed to be able to make progress. Finding opportunities, wherever possible, to break down these barriers, and restore and nurture relational ways of working can lead to significant impact. This could be as simple as making a telephone call over sending an email.
  4. Focusing on outcomes over process. Creating extra appointments and reducing Referral to Treatment waiting times are important measures of success and progress. However, we need to describe these goals in a human context – what does it mean for people? Working to create meaningful, locally generated, and person-centred goals can be a powerful way to mobilise and bring together disparate stakeholders around a common mission.

At PPL, we are experts in practical innovation, supporting partners to bridge the gap from ambitious plans and strategies to implementation on the ground. This means working in the messy reality of highly pressured systems and environments and supporting partners to make the shifts that are needed to enable new ways of working and ideas to achieve their intended impact.

We can help you to:

  • Engage with a variety of stakeholders, including frontline staff and citizens, to build a clear, shared understanding of the current context and generate new insights and ideas.
  • Build innovation skills and capabilities within and across organisations in your place and system and create opportunities to test these skills in practice.
  • Develop actionable implementation plans that are co-owned with stakeholders, including staff and citizens.
  • Test and learn, moving from strategy to action by creating the structures for ideas to developed, adapted and tested in real time.
  • Measure your progress and impact, using data and delivery insights to establish the value of new solutions and make the case to scale.

You can get in touch with us by contacting Catherine, our Senior Innovation Lead or Kate, our Director of Innovation.

[1] Sparking change in public systems The 100 Day Challenge, Nesta