A large NHS Trust in the Midlands faced challenges in delivering efficient diagnostic Hysteroscopy procedures and managing Polypectomy/Malignant Gynae procedures. They needed a solution to improve patient throughput while maintaining the quality of care. The Trust also aimed to reduce costs and optimise the utilisation of their community hospital theatre downtime, which meant the service had to be delivered from 3 different sites.
A large NHS Trust in the Midlands partnered with YMS to address challenges in delivering diagnostic Hysteroscopy procedures, including Polypectomy/Malignant Gynae procedures. YMS provided highly skilled Clinicians to run weekday lists, offering services at three different sites: Melton, Loughborough, and Hinckley. To maximise cost efficiencies, they utilised the community hospital’s spare theatre space for Outpatient Hysteroscopy procedures. Each day, they conducted approximately 12 Hysteroscopy procedures, including Biopsies and Intrauterine System (IUS) and Intrauterine Device (IUD) insertions. The YMS team ensured prompt dictation and approval of all clinic letters on the same day, prioritising patient throughput without compromising patient care. They also ensured that urgent 2 ww referrals were escalated appropriately. YMS provided monthly capacity to the trust and accommodated last-minute requests, enabling increased patient throughput. YMS consistently delivered clinics on time, within budget, and met cost-efficiency goals. Our successful partnership extended to other specialties, including Ophthalmology and Gastroenterology, showcasing insourcing expertise.
YMS collaborated with the trust to provide diagnostic Hysteroscopy procedures at three different sites. We ensured prompt dictation of clinic letters, swift approvals, and timely escalation of urgent referrals. YMS offered monthly capacity to the trust, accommodating last-minute requests to enhance patient throughput. Our service seamlessly integrated with the trust’s existing provision, leveraging the community hospital's theatre downtime to optimise cost efficiencies.
The partnership with YMS allowed this trust to:
A large Trust in South Yorkshire faced challenges in coping with their elective backlogs of non-admitted Gynaecology patients due to the pandemic, workforce challenges and increasing patient demand and the average referral to treatment rate in February 2024 was 16 weeks with 1600 patients without a scheduled appointment.
In February 2024, YMS was commissioned to provide 'One Stop' General Gynaecology outpatient clinics, utilising the Trust's natural downtime on weekends to boost efficiency without affecting regular operations. The YMS model featured a multidisciplinary team, including Consultants, Nurse Chaperones, and Ultrasound Sonographers, operating across four rooms each day. This approach aimed to reduce the need for follow-up visits, increase discharge rates where clinically appropriate, and optimise the use of Consultants' time, while enhancing the experience for patients who had been waiting long periods, ensuring they got the most from a single visit.
By May 2024, average wait times had dropped to 6 weeks, with no patient waiting more than 65 weeks. YMS's experienced teams treated 20 patients per day, seeing over 160 patients each weekend. Administrative duties, such as dictation and approval of letters, managing investigations, and handling urgent findings, were efficiently managed by pre-approved insourcing clinicians, preventing additional strain on existing staff.
YMS also oversaw the transition of patients from general gynaecology clinics to other subspecialties like vulval clinics, and managed referrals to a Consultant-led outpatient hysteroscopy service. The service remained highly flexible, allowing the client to scale capacity as needed, all while maintaining sub-tariff pricing. Consultants were subject to stringent clinical governance through tailored KPI reports, with conversion rates monitored and communicated to the Trust on a weekly basis, enabling better planning for other aspects of the care pathway outside YMS’s scope.
YMS worked closely with the Trust to mobilise within weeks of contract award. 4 Consultant led clinics ran every weekend where in total YMS treat 863 patients. YMS effectively reduced their Patient Treatment List (PTL) and delivered a successful patient focussed ‘One Stop’ general gynae service.
YMS allowed the Trust to improve patient throughput and promote as much ‘clock stops’ at first attendance as clinically possible whilst offering significant savings against national tariff to ensure the service didn’t compromise budgets.< /p>
Quality outcomes from YMS’s Outpatient service can be evidenced in the below conversion rates:
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, they required a solution to manage large patient throughputs within a short timeframe. The Trust also aimed to reduce costs and optimise the utilisation of their recently converted COVID centre which meant the service did not interfere with existing operations.
A large NHS Trust in the South West partnered with YMS to inject capacity to see 1700 patients within a 3 week timeframe. YMS provided highly skilled Obstetrics and Gynaecology Consultants, Gynaecology Nurse Chaperones to run Outpatients clinics across 3 consecutive weeks, including weekday and weekends. YMS were given 1 week to mobilise services and to meet the trusts tight deadline. Each day, our teams conducted 20 first outpatient appointments for general Gynae patients per room, often running up to 8 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. Our clinics were delivered on time, to quality, within budget, and met cost-efficiencies.
YMS, with the collaboration of the trust, mobilised services within 1 week of contract award. We ran 2 clinics on the first day, upping to 8 rooms per day within only a few days. We saw high quality patient care and high satisfaction rates through our responsive and effective mobilisation plans. YMS captured clinical outcome data by Consultant, whereby we capture conversation rates by day, these are then benchmarked against to ensure we are managing the quality output and keep on top of any anomalies. These are then presented back to the trust in a weekly quality assurance report.
The partnership with YMS allowed this trust to:
Quality outcomes from YMS’ Outpatient service can be evidence in the below conversation rates:
We have worked with YMS for a number of years, predominantly for endoscopy and cystoscopy provision, specifically backfilling sessions. More recently, they have assisted us with gynaecology support in terms of supporting our hysteroscopy service. All clinicians provided have been substantive NHS employees, providing us with assurance of quality. YMS has been reactive to our needs, often at short notice, and has mobilised swiftly where we have needed them to. Their approachable leadership and commitment to their promises have given us the confidence to continue working with them. On the very few occasions we have had concerns, these have been addressed quickly and to our satisfaction.
Operational Lead for elective services - Community Hospital (UESC)
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