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Elective Care: Tackling Challenges with Digital Solutions

The latest NHS wait times data has revealed that - once again - the size of the total elective care wait list has increased to a record level, reaching around 7.5 million in May.

This figure has risen dramatically since the pandemic, with systems and providers struggling to return to - and surpass - pre-COVID activity levels to reduce the elective backlog.

Elective Care: Tackling Challenges with Digital Solutions

Likewise, performance against the target to have 92% of patients waiting less than 18 weeks - last met in 2015 - has deteriorated significantly, with only 60% of waiting patients in the target time frame in May.

Similar difficulties are being experienced in other areas of planned care, with many cancer wait metrics not yet returning to their pre-COVID levels of performance. Additionally, in diagnostics, 26% of patients have been waiting longer than 6-weeks for a test, far above the 1% target.

Given the scale of the challenge, systems and providers are seeking transformation opportunities to reduce wait times fast whilst improving outcomes and the quality of care for patients. At the same time, a challenging financial environment has created pressure to find cost savings.

Whilst here has been great progress in reducing the number of some of the longest waiters, there is a risk that 2023/2024 activity targets, and targets to eliminate 65-week and 52-week waiters, will not be met.

Digitally enabled elective recovery: the opportunity

At The PSC, we believe that digital and data solutions have the potential to drive elective recovery efforts forward though transforming pathways and enabling the delivering care in new ways, all whilst unlocking financial efficiencies. Broadly, there are 3 areas that digital and data can be seen as working across in elective care:

Managing demand - digital and data initiatives can reduce demand on secondary care services through prevention, remote monitoring and referral optimisation. Examples of solutions being deployed across the NHS include apps and devices for patients to self-manage their condition and report symptoms, as well as the automatic screening of inappropriate or red-flag referrals.

Increasing capacity - digital and data solutions can enable the delivery of care outside of traditional secondary care settings, including at home. Examples of this include virtual consultations and virtual wards, as well as the connecting of new capacity (e.g surgical hubs) to the wider health system.

Improving productivity - digital transformation can improve productivity by automating and optimising processes so that existing resources are more fully utilised. Opportunities that could be pursued in this area include combined wait list and theatre management tools, e-rostering and diagnostics networks.

The curation of a digital elective portfolio that identifies high-impact initiatives and solutions in these areas will quickly help systems and providers in their elective recovery efforts, whilst generating cost savings.

Curating a high-impact digital elective portfolio

Whilst the opportunities for digital and data in elective care are great, there are risks around misalignment, imbalance, and resource and staffing constraints that may limit the overall impact of a digital elective portfolio. We have set out the below steps to mitigate against these, based on The PSC’s experience supporting health systems with digital strategies.

  1. Given the range of potential initiatives, there needs to be a clear view of all the options available and how they compare to what is already in place, so that high-impact opportunities are not missed, and so that resources not duplicated.
  2. Initiatives need to be prioritised according to local need to ensure efforts are focused in high impact areas.
  3. Digital and data solutions need to be aligned across the portfolio to realise their full potential (for example, to maximise interoperability).
  4. Effective and sustainable implementation requires staff training and the adaptation of processes and pathways, as well as long-term funding.

By following these, systems and providers can curate an aligned digital elective portfolio that targets investment in high impact areas, realising the full enablement potential of digital and data in elective care.

It's evident that the challenges associated with elective care in the NHS are significant, with growing wait times and struggles to meet performance targets. The PSC recognises the potential of digital and data solutions in driving elective recovery efforts forward. By focusing on managing demand, increasing capacity, and improving productivity, these technologies can transform pathways and enhance patient care while unlocking financial efficiencies.

The PSC's expertise in developing digital strategies can be instrumental in curating a high impact digital elective portfolio that addresses local needs, prioritises initiatives, ensures alignment, and facilitates effective implementation, ultimately driving positive outcomes in elective care.

For more information on how The PSC can support healthcare organisations in this endeavour, please contact Danny Silk at

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