ENT Case Studies

Paediatrics Audiology Case Study in the Midlands

Challenges

A trust based in Midlands faced significant backlog within their Paediatric Audiology service. This was due to a limited staffing pool within the Trust and help was needed to improve their current waiting lists. The request was for YMS to provide additional capacity within their service, so those long waiting patients between the ages of 0 – 18 years could be seen. It was requested that the service to be provided was to include a review of the patient’s history, a hearing assessment and a clinical outcome.

Delivery

YMS collaborated with the Trust to provide the support needed to reduce the wait times within the Audiology service. The initial request was for the YMS team to see routine paediatric patients only however there was an additional request by the Trust for the support to be extended to also seeing those cohort of patients with complex needs.

The service ran for a total of 4 months and YMS provided the Trust with a team of experienced Paediatric Audiologists to deliver the contract, led by a Senior Paediatric Audiologist. When the project commenced in June 2024 the Trust had a total of 670 patients on the waiting lists. By the time the project ended in Sept 2024 the waiting lists had reduced to 119 patients. With the support of YMS delivering clinics alongside the Trusts regular clinics, the Trust was able to see a significant reduction in the Paediatric Audiology waiting lists.

Paediatric Audiology Waiting List line graph showing waiting list dropping cerca 700 over 8 month period

As part of the end-to-end service, YMS provided the Trust with weekly KPI reporting which included Governance data on any incident & complaints. Each week YMS held a weekly touch point meeting with the key stakeholders of the Trust to review the data provided and discuss any issues or complaints which may have arisen.

Results

The partnership with YMS allowed this trust to:

  • A total of 243 patients being seen between June 24 – Sept 24
  • A total of 67% patients being discharged from the service where clinically appropriate
  • A total of 24% patients requiring a follow up appointment
  • Zero incidents, near misses being reported
  • 0% of patients requiring further or urgent treatment
  • 100% of patients reporting they were either happy or extremely happy with the service YMS provided
  • 100% of patients agreeing that the team were kind and caring

Quality outcomes from YMS’ Outpatient service can be evidence in the below conversation rates:

  • O Serious Untoward Incidents
  • 0 Negative Patient feedback
  • 0 Negative Trust feedback
  • 617 patients booked
  • Low DNA rates of 6%, 5% of these DNA’s had a desktop review whereby the Consultant reviewed their notes, requested any necessary investigations and discharged where appropriate back to the GP and stopping to clock on their RTT pathway
  • 26% of patients referred for imaging
  • 48% of patients referred for Pulmonary Function Tests (PFTs)
  • 1% listed for Sleep Studies
  • 6% of patients referred for Sputum
  • 0% of patients referred for Mannitol Challenge
  • 37% patients referred for blook work
  • 3% incorrect referrals

Patient Feedback

Listed below are several examples of patient feedback, highlighting their experiences and insights regarding the care and services they received.

  • "Professional and friendly service, thank you!"
  • "Great service. Calm and great with our daughter."
  • "Very calm environment to put my child at ease. Information and answered questions without being rush."
  • "Pleasant staff, great with children and very quick and efficient."
  • "It was calm and quick. The staff were brilliant with my son"

Supporting Outpatient Capacity for a Major NHS Trust in the South West: A Recent Partnership with YMS

Challenges

A large NHS Trust in the South West faced challenges in providing enough capacity to meet their demand for first outpatient appointments, with patients often waiting a long time to be seen. With an ongoing struggle to recruit more substantive or locum Consultants due to their remote location, they required an insourcing solution to support their elective recovery plans and meet their patient demands.

Description of Services

A large NHS Trust in the South West partnered with YMS to inject capacity to see 617 patients within a 3 month timeframe. Due to their remote location, YMS provided 7 consecutive days capacity to the Trust with experienced NHS substantive Consultants working through their annual leave, not compromising on quality but also addressing the challenges in coordinating Consultants from different parts of the UK to such a remote area. YMS provided highly skilled Respiratory Consultants, for 3 consecutive months, including weekday and weekends. Each day, our teams conducted 18 first outpatient appointments for general Respiratory patients per room, often running up to 3 rooms per day.

Our Consultants were also responsible for appropriately managing the admin generated from their outpatient clinics to ensure no burden was placed on the substantive teams, which included dictation and approval of letters, managing investigations and any urgent findings appropriately as well as seeing their patients in follow up remote non patient facing clinics. Our clinics were delivered on time, to quality, within budget, and met cost-efficiencies. We delivered weekly reports which also included outpatient conversion rates to aid the trust in appropriately planning diagnostic and theatre capacity to prevent any bottlenecks.

Delivery

YMS, with the collaboration of the Trust, mobilised services within 2 week of contract award. We ran up to 3 rooms per day delivering high quality patient care and whilst achieving high satisfaction rates. We reduced their Patient Treatment List (PTL) allowing their substantive workforce to see routine referrals and reduced their Referral to Treatment rates to YMS. YMS captured clinical outcome data by Consultant, these were then benchmarked against Clinician to ensure we are managing the quality output. These were then presented back to the Trust in a weekly quality assurance report.

Results

The partnership with YMS allowed this trust to:

  • Improve patient throughput and quality of care for First and Follow Up Outpatient appointments.
  • Benefit from YMS's responsive and approachable approach, addressing concerns promptly and to the Trust’s satisfaction.
  • Significant cost savings against national tariff

Quality outcomes from YMS’ Outpatient service can be evidence in the below conversation rates:

  • O Serious Untoward Incidents
  • 0 Negative Patient feedback
  • 0 Negative Trust feedback
  • 617 patients booked
  • Low DNA rates of 6%, 5% of these DNA’s had a desktop review whereby the Consultant reviewed their notes, requested any necessary investigations and discharged where appropriate back to the GP and stopping to clock on their RTT pathway
  • 26% of patients referred for imaging
  • 48% of patients referred for Pulmonary Function Tests (PFTs)
  • 1% listed for Sleep Studies
  • 6% of patients referred for Sputum
  • 0% of patients referred for Mannitol Challenge
  • 37% patients referred for blook work
  • 3% incorrect referrals

ENT Case Study: North West of England

Challenges

A large Trust in the North West of England was facing challenges to meet their demand within their ENT service and required support to help reduce their current backlogs. They required an insourcing solution to support their elective recovery plans and meet their patient demands which included 1st outpatient appointments, diagnostics and follow ups. This meant that those patients who had long wait times could be seen and treated for their condition without causing any further delay which potentially could cause long term effects to their overall health.

Delivery

YMS collaborated with the Trust in the North West of England to run a One Stop Clinic on weekends, as to prevent any unnecessary steps and repeated episodes of care in the patients journey, whilst also not affecting the day-to-day operations of the Trusts. The original ask was a weekend model for PTA’s which was a Consultant Led clinic with a Nurse and Audiologist. The service started in November 2023 and ran every weekend with a total of 4 rooms per day. This allowed for maximum capacity and a high throughput of patients without compromising on quality.

The Trust then identified an additional need for audiologists’ clinic to support with bottlenecks generated from the weekend clinics for more specialist audiology services such as vestibular assessments. The request was made and within a week YMS created additional capacity with 145 clinics being created and onboarded 8 additional audiologists to deliver the service. With the new model in place an average of 620 patients were seen per a month and 155 patients on average being seen per weekend. A range of diagnosis were carried out depending on the patients’ needs which included Hearing Aid Moulds and Fittings, PTA, VNG, BAHA, Tinnitus Management, Hearing Therapy, Paediatric Assessments, ECochG and OAE. YMS delivered weekly reports which also included outpatient conversion rates to aid the trust in appropriately planning diagnostic and theatre capacity to prevent any bottlenecks, as well as governance assurance data which included KPIs, patient feedback, quality metrics.

Results

The partnership with YMS allowed this trust to:

  • Improve patient throughput and quality of care for First and Follow Up Outpatient appointments.
  • Utilise their room and equipment downtimes at weekends
  • Virtually eliminated their waiting lists
  • Benefit from YMS's responsive and approachable approach, addressing concerns promptly and to the Trust’s satisfaction.
  • Significant cost savings against national tariff

Service summary

  • 3416 patients seen since the November 2023
  • 262 patients DNA’d, 8% of patients booked. However, of those that did DNA, a desktop review was completed and moved all patients along in their pathway, so the time allocated for their appointment wasn’t wasted
  • 725 patients were referred to imaging, 23% of patients seen
  • 307 patients were referred for diagnostics, 10% of patients seen
  • 158 patients were referred for surgery, 5% of patients seen
  • 5 patients were referred for suspected cancer
  • 56 patients were referred to another speciality, 2% of patients seen

1574 patients were discharged, which is an incredible 48% of patients

With the efficiency and delivery of the service YMS provided, the Trust confirmed the backlog was tackled a lot quicker than originally planned and the waiting lists was cleared in a total of 5 months. This cost saving for the Trust calculated to be around £68k against national NHS tariff.

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