A series of checklists to support NHS spinal teams to better maintain elective capacity leading up to and through winter is now on offer from the Getting It Right First Time (GIRFT) team.
The new guidance – which brings together advice, useful checklists and resource links, including examples of good practice, in a concise format – aims to improve the flow of patients from primary care, through secondary and tertiary care and on to quaternary specialised care where required, which in turn can help ease the impact of winter pressures on elective waiting times.
The guidance was developed as a result of shared learning from GIRFT’s Further Faster work on spinal services. Further Faster is a GIRFT programme bringing together trust clinicians and operational teams with the challenge of collectively going ‘further and faster’ to transform patient pathways and improve access and waiting times for patients.
The checklists offer actions for:
- Non-elective spine surgery: eg; Consider non-essential diagnostics and treatments on an outpatient basis to facilitate early discharge.
- Elective spine surgery: for both non-admitted and admitted patients (including patient-centred actions for time of listing, pre-admission and day of surgery).
- Optimising ward capacity: eg; Optimise the patient with all perioperative care concerns discussed and dealt with, including consideration for support at home on discharge.
- Capacity challenges: covering maintaining activity, maximising opportunities and modifying processes.
Links to associated GIRFT resources and examples of good practice are also included – for example, details of how the team at Northern Care Alliance NHS Foundation Trust (NCA) has improved day surgery rates in their posterior lumbar decompression/discectomy pathway, and the process and achievements of the team at University Hospitals of North Midlands NHS Trust (UHNM) in running a Saturday spinal surgery super-clinic to see their longest waiting new patients.
“Spine services in England are often challenged through the year but especially during the winter months. Along with staff sickness during winter, this can have a significant adverse impact on elective activity and a deterioration of referral to treatment times for patients awaiting spinal surgery. This guidance has been developed to provide options for spinal teams to help prevent the recurrent impact of winter on elective waiting times which can reduce the national ability to achieve waiting time targets.”
