How improved analytics can improve NHS waiting times

20 March 2023 5 min. read

Digital transformation continues to play an important part of healthcare strategy for the NHS. Richard Hartill, Client Manager, at IT Consultancy Northdoor, explains how modernising data infrastructure can help reduce waiting times in accident and emergency departments, and more.

Digital transformation continues to play an important part of healthcare strategy for the NHS. At the heart of these changes are the improvements to front-end and patient services. Whilst some of these improvements are hard to quantify immediately, other projects have shown real improvements for patients and allowed Trusts to hit targets and improve patient experience.  

One example of the NHS and government trying to improve patient experience is the four-hour standard waiting time for accident and emergency (A&E) departments. It was introduced by government in the early 2000’s and is the standard method for monitoring attendances at all types of A&E departments. The four-hour standard measures the total time patients spend in A&E, from the time they arrive to the time they leave department, to be admitted, transferred or discharged.  

Richard Hartill, Client Manager, Northdoor

Even before the pandemic hit many A&E departments were struggling to hit the four-hour standard waiting time. However, Covid-19 placed further strain and pressure on adherence to the waiting time standard, and many Trusts are struggling to recover.  

The difficulty of dealing with an increase of patients entering A&E departments particularly during the early stages of the pandemic in the UK and the number of staff who were off having contracted Covid-19 was well documented. These issues continued as the country emerged from the worst of the lockdown and pandemic.  

Most NHS Trusts know that they already have much of the information they need to help reduce waiting times in A&E departments and to ensure adherence to the standards and targets required. However, gaining access to this information in a timely manner that ensures that decisions can be made quickly with the very latest data has continued to be a challenge.  

Maidstone and Tunbridge Wells NHS Trust  

A good example of an NHS Trust using digital transformation to gain real benefits is Maidstone and Tunbridge Wells NHS Trust. The Trust provides a full range of general acute services and some areas of specialist complex care to around 560,000 people living in West Kent and East Sussex.  

Prior to implementing a modern Business Intelligence (BI) reporting system, reporting on operational and support services at the Trust was carried out manually. Although designed to help improve hospital services and provide assurance to the Executive Management Team, Board, Commissioners and Regulators, the lack of automation meant data was difficult to collate, often not wholly accurate and was only being provided once a day. The Trust realised the need to introduce a modern BI platform that could produce accurate reporting to operational, clinical and managerial teams near real-time.  

The implementation of a modern BI solution has allowed the Trust to move from a manual process to a fully automated environment. The best example of this is the impact this has had on the accident and emergency departments (A&E), where the Trust typically see 500-600 patients a day across two sites. To manage this level of demand and adhere to the four-hour standard is a huge challenge and creates real pressure on operational and clinical teams. Trying to ensure that the flow of patients through the A&E department is optimal to ensure the best experience for patients, but also to comply with performance standards means that access to good quality, timely information is critical.  

Using a modern BI platform, the A&E operational and clinical teams now have access to close to real-time views of statistics via Power BI dashboards presented on monitors within their department. This has enabled staff to better monitor and manage resources and patient flow, which in turn helps to meet the A&E waiting-time targets.   

The new platform has also enabled the legacy platform and report creation process to be decommissioned. Previously, the Trust’s BI team had to manually collate information which had been recorded on various pieces of paper and Excel spreadsheets to be able to produce a daily report providing information on patients and resources within the A&E department. As this report could only be run once a day, the output was a point in time snapshot of the department and therefore limited in its use and benefit. This process is now fully automated with dashboards being updated every 15-minutes.  

The result of this is that in a recent analysis of NHS A&E waiting times data, Maidstone and Tunbridge Wells NHS Trust came second within a table of over 100 Trusts measuring the shortest A&E waiting times. By embracing digital transformation and implementing solutions that make a real difference to NHS teams and patients, MTW has been able to cut waiting times, ensuring more patients are seen quickly.  

An added benefit of this particular project was that by nature of the system design it has meant that the system use and its operational cost is shared by multiple NHS partners, providing access to enterprise-level BI technology which otherwise may not have been affordable had each participating organisation had to pay for this individually.  

With the NHS under more strain than ever before, turning to innovative solutions (and ways of delivering solutions across local systems) will become increasingly important. Although budgets are under huge strain, Trusts should not be looking to reduce investment but look for ways to share costs, gain access to innovative solutions, which if designed well, can make a huge difference to staff and patients.