Introduction – Jackie Hanson and James McLean, Joint Chief Nursing Officer, NHS England North West

Thanks to the hard work of NHS staff across the North West, we have made good progress with recovering NHS services following on from the COVID-19 pandemic and in reducing the number of longest waiting patients.  These achievements have been made against a backdrop of significant pressure on services, increased flu and Covid levels impacting on demand, staffing and bed occupancy.

Recovering NHS services isn’t just about working harder, we need to think differently and deliver services in new and innovative ways.

Since the publication of the national elective recovery plan in February 2022, NHS teams across the region have been working hard to transform the way we offer patients care by separating emergency and elective, getting the basics right, rethinking outpatient care delivery, implementing best practice in clinical services and empowering patients to be partners in their own pathway. 

It’s good news that across the North West the total number of patients waiting more than 18 months for an appointment has now reduced by 93% since September 2012 to 1,719.  The number of people having an appointment at their GP practice was 9% higher in February this year compared to March 2019; 9% more people were seen as elective day-case appointments during February, compared to March 2019; and within the last 12 months, the overall volume of patients waiting for diagnostic tests has reduced by 8%.  In addition the number of people waiting longer than 62 days since their cancer referral has reduced by 3,305 from a peak of 7,397 in October last year. However overall, roughly 1:6 people are awaiting planned hospital care. 

In recovering NHS services, our focus has been to ensure that health inequalities experienced by some of our communities are not made worse, and that people who are waiting longer receive support and advice so that their condition does not get worse.

There are a number of different schemes such as the Greater Manchester ‘While You Wait’ and the Lancashire and South Cumbria ‘Set for Surgery’ initiatives; and in Cheshire and Merseyside an AI software system has been introduced to identify previously “hidden” patients at high risk of chest infections, then intervene with ‘pre-habilitation’ to avoid complications from surgery.

The NHS is changing how we deliver outpatient services so that patients can be seen more quickly and can access and interact with our services in a way that better suits their lives. By offering patient’s telephone or video consultations when appropriate, empowering people to book their own follow-up care as and when they need it, also known as Patient Initiated Follow Up or PIFU, and working with GPs to enable access to earlier expert advice, patients and their carers will have more control and more choice over how and when they access care. ​​

These interventions have proved safe and effective and mean patients save time, money and stress travelling to appointments when they don’t need to.  Implementing these interventions, as well as taking steps to address reasons patients might miss their scheduled appointments, helps us to deliver a more personalised model of outpatient care whilst also helping manage waiting lists as the NHS continues to focus on elective recovery.

Links to content: 

Longest waits for treatment continue to fall across the North West

Update on North West approach for outpatient transformation

Patient portal expansion across the North West

Expansion of theatre capacity at Bolton NHS Foundation Trust

Identifying different levels of risk to patients waiting for treatment

Positive feedback from Greater Manchester listening exercise on virtual wards

Online brain injury and stroke support scheme receives additional funding

Update on progress with diagnostics