Case studies

Supporting United Lincolnshire Hospitals Trust to significantly cut the Transthoracic Echocardiogram (TTE) Waiting List using Insourced Services (RM6276)


Background

Like many NHS trusts, United Lincolnshire Hospitals Trust (ULHT) was struggling to meet the six-week target for Transthoracic Echocardiograms (TTE). This challenge was exacerbated by a lack of spare capacity in the hospital-based departments due to an increase in demand and the backlog built up during COVID-19. Available space was identified in the newly created Community Diagnostics Centre (CDC) at Grantham, but ULHT had found it hard to recruit experienced British Society of Echocardiography (BSE) accredited staff due to the county’s rural geography and the need to deploy only highly experienced cardiac physiologists, capable of exercising the independence and autonomy required in a CDC environment.

The Solution

Partnering with the Alliance, ULHT were supported to open a new tender that was won by SET Healthcare Insourcing via the Insourced Services framework (RM6276), to provide an echocardiography service to offer diagnostics tests at Grantham CDC, enabling patients to be assessed in their local community outside of the busy hospital setting. Patient appointments are available seven days a week, with 24 patients each day assessed across the two-room facility. The project commenced in May 2023.

The Results

Over 6,000 patients have been booked for a scan, resulting in a significant reduction in waiting times. Across ULHT, as of May 2024, 93% of TTE patients were seen within six weeks.

Subsequently, the trust saved more than £60,000 due to the framework rates being below tariff and by using existing trust premises, booking and reception staff.

The trust benefited because:

  • Twelve patients were seen per day, per room, reducing the waiting list quickly
  • Experienced staff are in place that don’t need supervising, reducing pressure on the substantive team
  • They work to the same Standard Operating Procedure as the trust, with images available for cardiologists to view as the trust system is used.

Patients benefited because:

  • The CDC is conveniently located, it has free parking and is fully accessible
  • Patients are seen more quickly and in a calm environment
  • The service is available seven days a week, with weekend appointments being popular due to not having to take time off work

SET Healthcare Insourcing has ensured quality as all team members are BSE accredited, with at least two years’ post accreditation experience. 

The team has focussed on technical excellence and patient satisfaction which has been very successful. The waiting list has been reduced more quickly meaning patients have been diagnosed and treated sooner, reducing hospital admissions.

Nathan Hall, NHS England Deputy Director Diagnostics – Physiological Science, said that 10% of all echo scans were carried out in CDCs. He commented that the ULHT Cardiology Department had seen the greatest improvement in waiting list numbers over the past 18 months. 

Joanne Barton, Senior Category Manager at NHS Workforce Alliance, said: “By partnering with us, the team at United Lincolnshire Hospitals NHS Trust has transformed the way it delivers safe and effective echocardiology to patients in the Grantham area.

This is a model which could be replicated across the Trust, at future Community Diagnostic Centres1, and in trusts across the country.

“It is just one way in which our regional teams of workforce experts can support your colleagues to bring down waiting times for patients and provide the best healthcare services to your community.”

Tina Shires, Category Manager at NHS Workforce Alliance, said: “Our hard-working Insourced Services colleagues have worked like an extension of the Trust’s own team, helping them to overcome the area’s challenging geography to establish a highly experienced Transthoracic Echocardiogram (TTE) function for the Grantham Community Diagnostics Centre.

“This project has not only cut waiting times for patients, meaning fewer hospital admissions, but it has also saved our trust colleagues £60,000 — money which can be reinvested into other vital healthcare services.

“It is a prime example of how we always put patient care first – one of the core values of the NHS Workforce Alliance.”

1Construction work underway for two new NHS community diagnostic centres – United Lincolnshire Hospitals (ulh.nhs.uk)

Future

ULHT will be opening two more CDC services to bring diagnostics to the heart of communities and SET Healthcare will continue to work closely with NHS Workforce Alliance to deliver excellence for trusts and patients.

Testimonial

Sally Miller, Clinical Services Manager at ULHT, and Edd Wallis, Cardiology Manager/Principal Cardiac Physiologist at ULHT, said: “ULHT and SET Healthcare have worked together to ensure the success of the Grantham CDC by putting the patients of Lincolnshire first and striving for a great patient experience.

“ULHT and SET have worked closely, meeting regularly and ensuring clear communication lines and feedback processes throughout the joint venture.”

If you’re interested in how the Alliance team can support your organisation in a similar way, please don’t hesitate to get in touch.

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