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Sustaining Outpatient Productivity Improvements: Lessons from Two NHS Divisional Directors

Webinar: Sustaining Outpatient Productivity Improvements
Date: 23/10/2025
Speakers: Andrena Weston, Divisional Director at Shrewsbury and Telford NHS Trust; Sian Webley, Divisional Director of Operations at Walsall Healthcare NHS Trust; Samantha Sullivan, Delivery Director, Four Eyes Insight
Chair: Stephen Dorrell, Chair, Prism Improvement and Four Eyes Insight

“Earlier this year, NHS Confederation’s Jim Mackey famously called for healthcare leaders to “tear up the outpatient model” and rebuild it better. For many trusts struggling with growing waiting lists and limited resources, this isn’t just rhetoric – it’s an urgent operational imperative.” – Stephen Dorrell, former Health Secretary and Chair of both Four Eyes Insight and Prism Improvement.

Getting the Foundations Right—and Keeping Them Strong

Transforming outpatient services is only half the battle. The real challenge? Making those improvements stick.

In a recent webinar, operational leaders from Walsall Healthcare NHS Trust and Shrewsbury and Telford Hospital NHS Trust shared their journeys of transforming outpatient productivity – and more importantly, how they’ve sustained those gains months and even years after consultancy support ended.

The Challenge: Doing More with Less

A poll of webinar attendees revealed that the number one challenge facing NHS trusts today is straightforward yet daunting: demand continues to grow while resources remain limited. Other pressing concerns included backfilling cancelled appointments, managing conflicting operational priorities, and maintaining staff engagement.

These challenges are familiar to anyone working in NHS outpatients. But what sets high-performing trusts apart isn’t just that they tackle these issues – it’s that they create systems that keep working long after the initial improvement project ends.

Building on Solid Foundations

Both trusts worked with Four Eyes Insight and Prism Improvement on projects focused on maximising existing capacity through better booking and scheduling processes. The approach was intentionally foundational:

◾Clean, reliable data to understand true clinic utilisation

◾Streamlined booking guidelines – condensing complex 15-page documents into simpler, actionable formats

◾Structured booking teams with clear rotas for bookings, either by phone or letter

◾642 meetings (6 weeks, 4 weeks, 2 weeks ahead) to maintain forward visibility

◾Backfilling processes to capture last-minute cancellations

◾Digital tools like broadcast messaging to fill gaps at short notice

The results speak for themselves. Andrena Weston, Divisional Director at Shrewsbury and Telford, highlighted that booked clinic utilisation improved dramatically from April (2025) onwards and they have calculated the number of slots to potentially 15,000 per year across all specialties, while the waiting list size decreased month-on-month. At Walsall – now two years into their journey, Sian Webley stated that utilisation reached 95% and DNA rates dropped from 11% to 8%.

The Secret to Sustainability: Make It Business as Usual

When asked what it takes to sustain improvements over two years, Sian Webley, Divisional Director of Operations at Walsall, was clear: “We’ve really tried to incorporate it as part of our business as usual.”

This isn’t about maintaining a separate “improvement project.” It’s about embedding the changes into weekly routines, governance structures, and performance conversations. At Walsall, the graphs below are reviewed by teams every week and reported to the executive team every two weeks through their elective care meeting.

But data alone doesn’t sustain change – people do.

Fig. 1: One of the graphs shown from Walsall Healthcare NHS Trust in the webinar.

Outpatient DNA rate

Empowerment, Engagement, and Energy

Perhaps the most striking theme from both trusts was the emphasis on team ownership and empowerment. Rather than dictating targets from above, leaders asked their booking teams: “What do you think you can do?”

This approach had several powerful effects:

◾Pride in achievements: Teams at Walsall are now “extremely proud” of their metrics and continued to drive improvements beyond initial targets

◾Autonomy and accountability: When teams own the performance improvement, they’re more invested in maintaining it

◾Morale boost: At Shrewsbury and Telford, feeding back booking utilisation improvements “significantly boosted morale and enhanced performance”

◾Problem-solving mindset: Senior leaders positioned themselves as barrier-removers, tackling everything from broken printers to more complex operational issues

Andrena Weston, emphasised how simple changes – like implementing rotas for booking team focus – provided “greater clarity” and improved performance. Meanwhile, standardising clinic structures through a booking governance group became “a real game changer” for data quality.

Harnessing the power of the patient voice

One often-overlooked element of successful operational transformation is involving patient relations teams from the start. At Walsall, bringing the patient communications team into the project paid unexpected dividends: patient complaints related to outpatients reduced by 14%.

“We don’t always include the patient voice in operational performance work,” Sian noted, “but they can help design and inform the processes that we’ve got in operational management.”

This patient-centred approach reinforces the “why” behind the work – something both leaders identified as crucial for maintaining engagement over time. Connecting improvements to tangible patient benefits – shorter waits, better access, fewer wasted appointments – keeps teams motivated when the going gets tough.

Overcoming Barriers to Sustainability

When asked about challenges to sustaining improvements, webinar attendees highlighted engagement and conflicting priorities as key concerns. Sian’s advice was practical:

1️ Maintain oversight structures: Don’t dismantle the governance mechanisms just because you’ve hit your target
2️ Continually refresh your vision: Keep pushing – 93% utilisation today, 95% tomorrow, 97% next year
3️ Remember that basics matter: “Getting these processes in bookings correct in the first place has paid dividends on managing what felt like an unworldly PTL post-COVID”

Andrena, just three months into embedding changes, asked Sian the question many trusts face: “How do we maintain the engagement?”

Sian’s answer centred on connection, reflection, and empowerment:
◾ Connect the work to the “why” are patients waiting too long for care
◾ Show teams how far they’ve come through regular data feedback
◾ Give teams autonomy to drive improvement themselves
◾ Create energy around the achievements and their impact on patients

What’s Next: Building on Success

With solid foundations in place, both trusts are moving toward more sophisticated transformation:

◾ Shrewsbury and Telford is continuing its digital health platform rollout and reviewing clinic templates and appointment timings
◾ Walsall is focusing on referral assessment to ensure patients are seen in the right setting, and exploring ways to maximise value-added appointments (reducing unnecessary “scan and come back” visits)

These next-level improvements are only possible because the fundamentals are secure. You can’t optimise clinic templates effectively if you’re not filling the clinics you already have. You can’t implement sophisticated digital tools if your booking guidelines are too complex for staff to follow.

Key Takeaways for NHS Leaders

For trusts embarking on outpatient transformation, or struggling to sustain improvements already made, the lessons are clear:

1️ Get the basics right first: Clean data, clear processes, and empowered teams create the platform for innovation
2️ Embed in business as usual: Sustainability requires integration into regular governance, not separate project structures
3️ Empower, don’t mandate: Give teams ownership of performance improvement and the autonomy to drive it
4️ Keep the patient voice central: Operational improvements should be grounded in patient benefit
5️ Maintain momentum: Continually refresh targets and celebrate progress to sustain energy and engagement
6️ Engage everyone: From nursing teams to patient relations to executive leadership, transformation requires buy-in at all levels

From Project to Business as Usual

As Stephen Dorrell noted in closing the webinar, these improvements demonstrate that change is possible, even if it doesn’t constitute “tearing up the outpatient model” entirely. It’s about doing things differently and better, for patients, staff, and the system as a whole.

The results from Walsall and Shrewsbury and Telford tell a compelling story: productivity improvements can be sustained, waiting lists can come down, and teams can maintain motivation – but only when the work is embedded as business as usual, owned by empowered teams, and connected to the fundamental purpose of improving patient care.

Two years on, Walsall is still improving. Three months in, Shrewsbury and Telford is already seeing results. The challenge now is for more trusts to follow their example – getting the foundations right, and then keeping them strong.

We would like to thank both Andrena Weston and Sian Webley for their time and contribution to this webinar.

You can learn more about outpatient transformation by contacting us here.
The full webinar recording is available to view here.

Webinar: Sustaining Outpatient Productivity Improvement

30-minute video

Speakers:

Andrena Weston, Divisional Director of Operations, The Shrewsbury and Telford Hospital NHS Trust

Siân Webley, Divisional Director of Operations, Walsall Healthcare NHS Trust

Transcript

23 October 2025, 12:30pm

Stephen Dorrell

Good afternoon to everyone. My name is Stephen Dorrell. Those with a very, very long memory may remember me from long ago as a health minister and I have been around for the health field ever since.

For this purpose, I am a director engaged with Four Eyes Insight and it’s a great pleasure to welcome you to this webinar, where we’re looking at an area of particular importance to Four Eyes certainly, but also to the health service and those who depend upon it. And that’s the question of outpatient productivity and how we can ensure that when we secure improvement in productivity in outpatients, those improvements endure and continue to the benefit both of patients and of taxpayers.

I’m going to offer a couple of thoughts before we start the webinar and then I’m going to introduce two people who know much more about it than I do. Indeed, will have forgotten more about it than I will ever know. But the thought of the importance of outpatients was very much the core of the NHS Confederation earlier this year when Jim Mackie famously said what we need to do is tear up the outpatient model.

I think everybody who cares about the health service that the outpatient model that we inherited is one that needs to be rethought, partly in order to deliver outpatient services more and more extensively in the community as one of the government’s clear objectives, partly in order to deliver outpatient services more efficiently so that that we can keep the finance director happy, but most importantly so that we respect the patients who rely on outpatient services and who find too often that the services don’t work in the way that they would want and we would want. So tear up the outpatient model and do it again, build it different, build it better is what we were challenged to do by Jim Mackey earlier this year and essentially that’s the theme that we are going to try to follow through.

In this webinar, how to do it and most importantly, once you’ve done it, how to make certain that those benefits continue to endure. Now I said we’ve got two people on the webinar who who do this day by day and one expert from Four Eyes in the form of Sam Sullivan, who’s director responsible for these services in Four Eyes.

But I’m going to ask first before going to Sam, I’m going to ask Siân Webley and Andrena Weston to introduce themselves. So Siân, first, why don’t you introduce yourself as the expert we know you to be in these services?

Siân Webley (WALSALL HEALTHCARE NHS TRUST)

Thank you, Stephen. Hi, everyone. My name’s Sian. I’m the Divisional Director of Operations here at Walsall Healthcare NHS Trust and my portfolio covers outpatients and elective care on behalf of the Trust.

Stephen Dorrell

OK. Thank you. And Andrena, please.

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)

Hello, I’m Andreena Weston. I’m acting divisional director of operations at Shrewsbury and Telford Hospital Trust. Within my portfolio sits outpatients and theatres and everything elective care. Thank you.

Stephen Dorrell

Fantastic. And so Sam, Samantha is very formal. I don’t think I’ve ever introduced you as Samantha, but Sam Sullivan, Delivery Director at Four Eyes, you’re going to lead us through this webinar.

Samantha Sullivan

Yeah, afternoon everyone. So I mean everything that Stephen said there, I’m sure it doesn’t come as a surprise to you. Outpatients is high on the agenda this this year. It’s where the patients sit, so the big risks sit in outpatients before people are in for their first appointment.

The general mass of patients, it’s an outpatient. So it’s one of the areas we’ve really got to get on top of and what we’re going to talk through today is the importance of setting the firm foundations. So how do we get the basics right that gives us the ability to build more innovative structures and transformational changes in outpatients. One of the key things that I think is important is how do we sustain that change once it’s actually been made.

So we’ve worked with Sian and Andrena on very similar projects over the last few years and what they’re going to talk through is what they’ve actually done since the projects have finished and how they’ve managed to sustain and continue to grow the improvements they’ve made in outpatients.

Before we get into any of the detail, we’re just going to do a quick poll just to understand what you feel your key challenges are in outpatients.

Poll:

What’s your biggest challenge in outpatients?

Competing priorities
Sheer scale of outpatients
Data quality
Demand growth/lack of resource and capacity
Sustaining results

Here we go. So you you’ll either see a poll that’s just jumped onto your screen or will be in your chats. If you can just submit your answer and close the poll and we’ll come back to that in a few minutes time.

I just want to give you a bit of an overview about the work that we did with these two projects and then I’ll hand over to some Q&A with the with the panel. So just in terms of how the projects are structured, then it’s generally a 20 week project starts with a deep dive insight and discovery phase and then moves through into implementation.

Now these particular projects were all about understanding how do we make the most of the capacity that we’ve got available to us. So the booking and scheduling processes and the teams behind the scenes that do all the hard work that make sure that we actually have the right patients in the right clinic.

The work involves a lot around 642 meetings, utilisation meetings, getting the data clean so that we really understand what we’re looking at and what we mean when we’re showing utilisation figures and then being able to physically have the right structures within the booking teams to fill that capacity.

So it’s easy to fill six, six weeks out, but actually the difficulty is keeping hold of those patients when cancellations start coming through. So a lot of the work was about how do we backfill those slots that are cancelled at short notice? How do we make sure that we’ve got the capacity within the booking teams to be able to handle the mass that comes through at short notice? and then how do we make sure we’re contacting the right patients to be able to do that?

Just going to have a quick look at what the poll is showing here.

So we’ve got 18 responses and I think, yeah, so, so general consensus, the problem that trusts are facing at the moment is the demand continues to grow and resources are limited. So how do we deal with that lack of capacity in the face of demand?

I think that’s a general theme that comes up when we do these sort of these sort of projects and we do a lot of work around demand capacity modelling, but actually all of these are issues that do crop up in outpatients and it’s interesting we’ve got a 17% split between three of them there, so equal relevance for those three.

As we move through. I think some of these points are likely to be covered off in the conversation. But what I’d like to do is just have some time to to look at the the actual results of the projects.

With Andrina and Sian and just talk to them about how they’ve managed to maintain those results.

OK. So SATH first, so Andrena, we’ve got three graphs here and they’re all showing some pretty stark trend lines. It would be great if you could talk to us a little bit about what the results have looked like for you off the back of the project and what it was that’s really helped you to achieve those benefits.

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)
Yeah, absolutely. So as you can see from the first graph, our total waiting list size has reduced and it is still continuing to reduce actually. And I think that is very much supported by the work that we have done with four eyes.

In terms of our 18 week compliance, you can again see a month on month improvement and again, we have no reason to believe that that won’t continue to do so. And more importantly really up to the right hand side is our booked utilisation. So this clinic utilisation and since we implemented or started the project with Four Eyes in April, you can really see that we have really started to improve our booking utilisation and we do think at this point in time we’ve potentially improved by 3-4 percentage points and we have calculated the number of slots that that actually represents and thats potentially 15,000 per year across all specialties.

In terms of the work, do you want me to just carry on in terms of the work and benefits, Sam?

Samantha Sullivan
Yeah, if you’ve if you’ve got any other points to make, go for Andrena.

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)
Yeah. So there have been lots of benefits with the work that we have done with, particularly with our own booking team because what we did, we found out that they’re working a little bit chaotically and through the work we’ve done with Four Eyes, we’ve implemented simple things like rotas, you know, one for phones, one for booking, and that’s really provided greater focus really in terms of where they are on a day-to-day basis, so they absolutely understand. So there’s been a real focus there which has improved our booking utilisation. I’ll stop there, Sam. Thanks.

Samantha Sullivan
Can I just ask, so since the project finished in the summer, have there been any fresh challenges that have come up that maybe you weren’t expecting or how has it all worked?

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)
Well, we we have had our challenges. I mean the the the things that we did implement when you were working with us back in April and and they’re difficult things to tackle, but they are so worthwhile doing.

So we’ve introduced those specialty booking guidelines and and we did think that you know when we looked at them, when your team looked at them with us in detail, some of them were really, really complex. Some of the booking guidelines were up to 15 pages long, so you’ve really helped condense that and simplify it. And now we’re able to move our teams around and they’re able to pick up that work and and go particularly supporting annual leave or sickness.

The broadcast messaging that you supported us with with Dr Doctor has really, really helped. So now we’re able to fill those last that those last those gaps really within clinics at the last minute and we’re able to fill those and rather than just ringing patients, we’re able to use broadcast messaging. So we are seeing an increase in in utilisation there.

The booking governance group, that was a real game changer for us really because we’ve we it’s enabled us to standardise around even just simple things like how clinics were structured and that has really improved our data quality.

We’ve introduced the 642 meeting for outpatients, which has been a real challenge and we are still getting to grips with that, but that has given us a real clear overview now that the whole of our clinic estate.

In terms of the benefits, I mean they are endless actually, but I think because we have seen that booking utilisation improvement and we’ve been feeding that back regularly to our teams, we have found you know that it really has significantly boosted their morale and consequently absolutely has enhanced their performance.

One of the challenges I would just highlight is because of the use of Dr Doctor now across the majority of our specialties, it’s sort of led to a definitely a reduction in phone calls, which is real positive, but it has increased the workload within the Dr Doctor platform. So there are occasions, where the teams do need to focus on that to obviously, you know, manage those queries, etcetera. But that that’s it for me really. It’s been really positive. Thank you.

Samantha Sullivan
Thanks, Andrina.

Sian, you’ve been at this for two years now. So it’s it’s great to see that actually the results are sustaining there as well. Here’s the graphs for Walsall.

So before we get into this. We’re going to put a word cloud out for everybody on the call. And what we’d like to do is just understand what are the challenges that you face when you’re trying to sustain productivity improvement.

Word cloud (participants enter their challenges):

What makes sustaining a productivity improvement difficult for you?

So I mean we’re talking about outpatients here, but really when it comes to the sustainability part, it’s it’s all the same across all services. So what I’d really like to know, Sian, is what’s what’s it taken from your team to be able to sustain this for two years?

Sian Webley (WALSALL HEALTHCARE NHS TRUST)
Thanks, Sam. So in terms of what it’s taken from the team, we’ve got real strong divisional and executive leadership when it comes to outpatient utilisation and what we’ve really done is try to incorporate it as part of our business as usual.

So the graphs that you see in here today are actually graphs that the team look at at least every week and we report to the executive team every two weeks through our elective care meeting. So we have really incorporated this part of kind of business as usual in terms of commitment from the admin teams who do the booking on a day-to-day basis.

We really tried to give them the autonomy to own this project as their own kind of performance improvement project and empower the teams. It has led to them being extremely proud of some of these metrics that you can see on screen today and they continue to drive performance improvement. So within kind of 6 to 12 months after working with Four Eyes, we were up at our target of 93% booked clinic utilisation and then kind of pushed the team further to say what what more do you think you can do?

And last year we got up to 95% utilisation this year again kind of pushing for 97. But you know that’s working with the teams, but giving them the autonomy and saying actually what do you think you can do and and they do strive to continue to improve that. The DNA rate has been my nemesis a little bit in this trust we started at 11%, got down to 9 with Sam and the Four Eyes team and are now hovering at around 8%. That’s taken some more kind of targeted work with the teams looking at high DNA rate clinics in particular, and we’ve had to do unfortunately some physical phoning of those patients which has really helped. But yeah, in terms of the commitment, it is a senior leadership commitment that this is the right thing to do for our patients and make sure we’re making full use of resources, but also from the teams in kind of owning the quality improvement, performance improvement.

Samantha Sullivan
Thanks, Sian. Can we see the the word clouds?

It’s my first time looking at one of these, so it’s really interesting. The way this works, if you’re not familiar with them, everybody’s written in their responses and then it’ll pop up with the the most common responses. So engagement and conflicting priorities coming through there is some of the key things that is stopping the productivity improvement that you might be seeing from your own projects from sustaining.

Sian, just thinking about those, those sort of challenges that have come through there when people are trying to sustain a productivity improvement, if you could offer some advice to somebody that’s just finished this sort of work, what would it be?

Sian Webley (WALSALL HEALTHCARE NHS TRUST)
I guess both the conflicting priorities and engagement. One for me would be, one – how you’re going to continue to maintain oversight. So I’ve mentioned you know we we have this as part of our business as usual and it really is embedded as business as usual. We have maintained kind of the slot that we had with Four Eyes for a task and finish group, we’ve maintained that slot and kind of developed it as an outpatient transformation group building on the success that we’ve already got.

The other thing that I’d mentioned is just continually reviewing and refreshing what you think your vision is. So I’ve mentioned you know you don’t just finish a project, you say, yeah, we’ve got to the target, we’ve finished the project. Now if we’d have done that with Four Eyes, we’d probably slip back to where we were. But that continual refresh of actually we’re we’re here at 93% now actually what can we do to go further because we all know in terms of conflicting priorities that, actually, this is just bread and butter, basic kind of OPS and us getting the processes right.

The conflicting priorities obviously come from actually when you’re trying to manage a massive PTL that’s out of control and sometimes actually taking it back to the basics will help you to deliver those improvements that you need in your PTL.

One of those old-fashioned phrases, isn’t it? How to eat an elephant a little bit at a time. But I do believe us getting these processes in bookings correct in the first place has has paid dividends on kind of managing and what felt like an unworldy PTL post COVID.

Samantha Sullivan
Andrena, so, so you’re three months in, things have started to bed in. I think I’ve, I’ve seen the teams like people are actually, you know, they’re following the process as it is all working. But like we said, the challenge is really sustaining that long term. So if you could ask somebody that’s been at this for two years one question, what would it be?

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)
So I think the main question would be how do we maintain the engagement?

Samantha Sullivan
Sian, what do you think to that?

Sian Webley (WALSALL HEALTHCARE NHS TRUST)
Shall I come into that? So just repeating on some of the other things I’ve said around incorporating it, it’s business as usual. There was a real feel for us in terms of connecting this to the why, and for us at the time that was patients waiting far too long for elective care treatment. So really trying to drive down that wait to first appointment.

I think these graphs that you’re seeing here and being able to re reflect to the teams where they’ve come from. Where they’re going and actually re reflecting those achievements to them and actually this was something to be really proud of and the teams are really proud of it. And then making sure that the teams have the autonomy to go away and drive this themselves, but knowing that we’re here as a senior leadership team to kind of unlock any barriers they’ve got so, you know, I’ve been involved in all sorts of really odd bits from kind of printers not working and causing lots of delays in outpatients to to even more tricky situations. So yeah, really empowering the teams, creating that energy around it as well. You know, I’m really lucky with the team here. They can see how far they’ve come. They can see the impact that we’re having on patients by improving access. And yeah, just getting getting that energy in the team to keep pushing and wanting to change and go further.

Samantha Sullivan
You know, one of the things I remember when we did the Walsall project that I thought was really interesting was the engagement from the patient communication team.

So Gareth [from Walsall Healthcare NHS Trust] got so behind this project, didn’t he? And he became one of the work stream leads, which isn’t the way that we would normally do it, to be honest, like they don’t normally get that involved, but actually I think probably because of his involvement, patients really felt the benefit and your complaints, patient complaints reduced by 14%, so it’s it’s a different type of benefit to the ones we’re showing here, but actually that’s a huge success as well.

Sian Webley (WALSALL HEALTHCARE NHS TRUST)
Yeah, that’s a really good point. So, yeah, when when we think about operational performance, we don’t always include the patient voice in our kind of patient relations teams, do we? But yes, here at Walsall, there’s a really strong patient relations team. And yeah, we brought them into the project and they, yeah, went out and worked with the community. We got feedback, didn’t we? We talked a lot about DNA rates out in the community. So yeah, don’t forget the patient in all this and they can help to kind of design and inform those processes that we’ve got in operational management.

Stephen Dorrell
Samantha, Stephen Dorrell, can I just you asked me at the beginning of this webinar and I didn’t do this, so that’s why I’m interfering now, not forgetting the patient and not forgetting other people on the webinar as well. If you’ve got a comment or if you’ve got a question you want to put to either to Andrena or to Sian, then please do put it in the chat and we will pick it up and try and ensure that the theme that might be burning your mind is is put to the panel so that this can become a discussion around the points of interest to the people who are on the webinar. A point I should have made at the beginning. Apologise for not doing so.

Samantha Sullivan
Thanks, Stephen.

So I suppose what’s interesting is, is what happens next. So you’ve got your foundations in place. You’ve both seen fantastic results and your utilisation is where you want it to be, your waiting lists are starting to come down. But like we said at the start, there’s so much going on in the outpatient space at the moment. This is just the beginning. So it’s really interesting to understand what what’s your next steps in that outpatient transformation. Andrena, do you want to talk about that a little bit?

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)
Yes, certainly.

So I think our next steps in terms of the outpatient transformation is to continue our journey with the Dr Doctor roll out. I think the teams have really embraced that, to be honest, it has been a real game changer and it’s something that we have just literally only introduced at the 1st of September, so there is still quite a lot of embedding to do with that.

I think for us as well what we do need to to understand really are our clinic templates and you know looking reviewing those and and yourselves and the team are with us at the moment to support us with that. But I think you know outpatients is, you know, all patients are seen in outpatients. So it is really, really important that we absolutely maximise our throughput and working with our team, particularly within the booking team is a centralised team. They absolutely do need to be supported.

And I think what we do need to do is to make sure that they have the tools available, digital tools available to do their jobs more effectively really.

And as Sian said, you know, our COO [Chief Operating Officer, Ned Hobbs] was previously the COO at Walsall and is very, very engaged with this process along with the deputy COO [James Wright]. So there is real support with us now we we feel like we’re doing it as a trust now and also that that patient buy in as well I think is is particularly important. But next steps really is really looking at our clinic templates and the timings of our appointments, which is a big piece of work, so thank you.

Samantha Sullivan
Certainly is. What about you, Sian? What’s going on at Walsall now?

Sian Webley (WALSALL HEALTHCARE NHS TRUST)
So for us last year we started referral assessment in some of our subspecialties. So reviewing those referrals before we kind of accept them if you like, looking at what we could kind of divert to advice and guidance. So didn’t need to come straight into a face to face appointment.

What I’m really keen to do now is obviously we’ve we’ve got the utilisation of our clinics now we’re filling the clinics, we’re still driving down the DNA rate. What I’m really interested in is are we seeing the right patients in clinics, so what I want to look at is actually what percentage of patients are coming to clinics and then going on to a diagnostic and actually whether we can flip that around to make sure that our appointments are value added.

Because you know everyone takes time off to go to a hospital appointment, you can sit for a delayed period unfortunately waiting in outpatients just to then be told that you need a diagnostic, and you know, I think that will help us again continue to drive down the PTL in terms of making sure that we’re adding value when the patient gets to see a consultant, it’s not just a you need a scan, go away and come back again. Actually just making sure that those are really value added and that we can maximise making sure that patients either have a decision to treat or are treated at their first appointment.

Stephen Dorrell
Just to draw out Sam, the the the question from Debbie in the chat was ‘were the outpatients department nursing team involved?’ and Sian has given a very emphatic yes to that and I’m sure Andrena would answer give the same answer as well.

Andrina the engagement of the nursing team.

Andrena Weston (THE SHREWSBURY AND TELFORD HOSPITAL NHS TRUST)
Yeah, absolutely. I was just typing it in the chat.

But yes, our our outpatient nurses are heavily involved and and particularly through our 642 process that that we have introduced and I think that is helping them, their engagement is really helping them support their staffing allocation and things like that. So yes, that they’re they’re pivotal, absolutely pivotal.

Samantha Sullivan
I think some of the the key messages coming through here is all about engagement really, isn’t it? So it’s that get get your foundations right before you move on to some of the more innovative stuff and that helps you to gain the confidence of of the clinical team and the Ops team. But I think engagement throughout is really key to make this a success and to make it sustain.

We’ve just got a couple of minutes left. I don’t know if there’s any other questions that people have got.

Stephen Dorrell
Tap away in the it gives a an opportunity. We’ve got a couple of minutes left and if there’s a question that appears in the chat, we’ll pick it up. But I’ll use the moment, if I may, just to say thank you first of all for attending the webinar. I would hope you found it instructive and helpful. And there will be a recording of the webinar that be sent via e-mail to everyone who’s attended and indeed we will forward it to anyone else who might be interested as well.

So, do you have a concluding comment, Sam?

Samantha Sullivan
Yes. So I suppose just to say thank you all again for for coming along today.

Outpatients is something I’m passionate about and I’m really pleased that it’s come to the forefront and suddenly it’s, you know, it’s hot topic. So it’s it’s nice to see that everyone is kind of rallying around trying to make our patients as successful as they can and starting to look at all this stuff in a bit more detail. So thank you all for coming today and that’s that’s it from me.

Stephen Dorrell
OK. And a huge thank you to Sian and to Andrina for sharing their experience with us and for saying for for demonstrating actually on the graphs you put on the screen. Thank you, the effectiveness of how you can make a difference.

These things are not cast in stone. It is possible to do it differently and to respond, even if that doesn’t constitute what Jim Mackie might call tearing up the outpatients model. It definitely involves doing it different and doing it better from everybody’s point of view.

So thank you to Andrina, thank you to Sian and thank you to Sam for organising it and most importantly, thank you to everyone for for joining. Good afternoon. We finished more or less on time. Thank you.

Ends.

Smarter Planning, Better Outcomes: The Impact of Demand and Capacity Modelling

The Impact of Demand and Capacity Modelling on Patient Care

I’m really passionate about the benefits of good quality Demand and Capacity modelling. It isn’t just about filling in spreadsheets—it’s about answering the real-world “what ifs” that leaders face every day. A basic model is a useful start, but the real value comes when you use it to test specific scenarios and co-design solutions with clinical and operational teams.

Samantha Sullivan, Delivery Director, Four Eyes Insight

In the dynamic world of healthcare, ensuring that patients receive timely and effective care is paramount. Across the country, NHS leaders face the same dilemma: how can we improve waiting times, while also protecting our staff from burnout? Demand and capacity modelling gives us the clarity to tackle those challenges head-on.

In this blog, we will explore how effective demand and capacity modelling can significantly improve patient care and satisfaction, focusing on reduced waiting times, improved appointment scheduling, and enhanced patient experience.

Understanding Demand and Capacity Modelling

On a basic level, demand and capacity modelling involves analysing various data points to predict future patient demand and allocate healthcare resources accordingly.

But It’s not just about crunching numbers — it’s about asking the right questions:

The questions you ask have got to be bespoke to you and specific to your problems.

▪️If we increase new outpatient activity, what will be the knock-on effect on follow-up demand?
▪️If consultants transfer appropriate work to nursing teams, how much capacity could that release?
▪️If suitable theatre cases move to a surgical hub, how many more complex cases could the acute site handle, and what extra resources would be needed?

From Data to Decisions

Demand and capacity modelling isn’t about perfection. It’s about clarity. When done well, it brings together operational knowledge, clinical insight, and data to help you design services around patient need.

According to Neil Mason, Senior BI Analyst at Four Eyes Insight, the key challenge is finding the baseline position, identifying demand at a suitably granular level and with sufficient confidence that the data is good enough to paint an accurate picture of reality.

“A busy provider facility may be configured in one way on paper, but in an entirely different way on the ground. Close collaboration is necessary between the analytical team and the clinical teams and managers to ensure that a clear picture is built up of what services are delivered, and where. The final challenge is understanding how demand is likely to change in the future, which is reliant on local knowledge and historical data to enable accurate forecasting.”

Why it matters – Enhanced Patient Experience

“Good capacity planning makes services more reliable, responsive, and resilient. It’s about looking ahead; not just reacting to pressure on the day.” Samantha Sullivan, Director, Four Eyes Insight.

We all know the benefits of better planning – less delays, less surprises and a smoother service, but how does this translate into the real world?

Ultimately, the goal of demand and capacity modelling is to enhance the overall patient experience. When NHS Trusts can predict and manage demand effectively, patients benefit in several ways:

1.Timely Access to Care: Reduced waiting times and improved appointment scheduling mean that patients receive care when they need it, without unnecessary delays. This is particularly important for patients with urgent or chronic conditions.

Example: Reduced Waiting Times – Gloucestershire Hospitals NHS FT

Cardiology services faced demand-capacity imbalances in ECHO and Cath Labs. Through analytics, pathway reviews, and staff engagement, we identified practical improvements without adding major resources.

Impact:

✅ ECHO: Backlog clearance in 22 months with small changes (extra patient per clinic, weekend sessions)
✅ Cath Labs: Better scheduling and utilisation (80%) could clear Angio backlog in 14 months
✅ 27 actionable recommendations to improve access and efficiency

2.Personalised Care: With resources aligned, clinicians can spend more time with patients and tailor care to their needs.

Example: Walsall Healthcare NHS Trust

Modelling revealed high DNA rates and underused clinics. Patient surveys and focus groups identified barriers to attendance. In response, the Trust introduced simpler, multi-language reminders via phone and mobile, a new travel expense reclaim process, and improved procedures to fill short-notice vacancies.

Impact:

✅ 2% increase in utilisation
✅ 2% reduction in DNA rates
✅ 14% reduction in patient complaints

3.Reduced Stress and Anxiety: Long waits and uncertainty can cause stress and anxiety for patients. By ensuring a smooth and efficient process, demand and capacity modelling helps create a more positive and reassuring environment for patients.

Example: Better Utilisation of Estate – Hillingdon Hospitals NHS FT

FEI worked with Hillingdon to build a robust business case for improving the utilisation of physical theatre estate. By modelling activity, bed needs, staffing, and finances, we identified opportunities to recover lost theatre capacity.

Impact:

✅ 614 additional sessions identified per year
✅ Capacity for 1,681 more patients
✅ 80% of dropped sessions recovered
✅ Ability to clear 52+ week waits in 11 weeks
✅ £1.2–£1.8m anticipated net income

Informed Decision-Making: Clear forecasts help providers communicate care journeys more effectively, building trust with patients.

Example: The launch of the New Heatherwood Side – Frimley Health NHS FT

Frimley Health aimed to make Heatherwood Hospital a dedicated elective orthopaedic centre. This required shifting other activity into the remaining sites — but with more clinicians moving out than in, there was a real risk that existing estate and capacity wouldn’t stretch far enough.

FEI developed a demand and capacity model to assess the impact of displacing services, comparing specialty demand with available capacity across the three sites. Working closely with clinical and operational teams, we tested scenarios to identify the changes needed to make the plan viable.

Impact:

✅ Demonstrated how activity could be redistributed safely across sites
✅ Informed decisions on increasing worked weeks (up to 49) and list duration (10 hours on all sites)
✅ Identified productivity gains (up to 50% of opportunities)
✅ Enabled the successful creation of Heatherwood as a high-volume orthopaedic hub, while protecting other specialties’ capacity

Conclusion

Demand and capacity modelling is a powerful tool for optimising services and improving patient care. By reducing waiting times, improving appointment scheduling, and enhancing the overall patient experience, NHS Trusts can deliver high-quality care efficiently. As national targets continue to evolve, the integration of advanced analytics will be key to achieving operational excellence and improving patient outcomes.

“If you’re unsure about investing in C+D modelling, my advice would be to think of it not as a data exercise—but as a decision-making tool. It helps turn uncertainty into strategy, and makes tough choices clearer, faster, and more grounded in evidence.” Samantha Sullivan, Delivery Director, Four Eyes Insight.

Case Study: Enhancing Surgical Productivity

Click here to read the full case study.

An NHS Elective Hub in North West England collaborated with Four Eyes Insight and Prism Improvement to implement a Theatre Improvement Programme over 20 weeks. This initiative aimed to optimise surgical productivity and address operational inefficiencies through innovative methods.

Key Outcomes

☑️ Additional Cases: The programme delivered 115 additional cases in 20 weeks, with a trajectory to achieve 679 additional cases for the full year.
☑️ Productivity Increase: High-Performance Listing (HPL) led to a 30% increase in productivity, significantly improving patient safety and reducing wait times.

Programme Overview

The programme focused on two main areas:

1️⃣ High-Performance Listing (HPL): This model refined workflows to overlap processes, minimising inefficiencies and increasing surgical activity.
2️⃣ Firm Foundations: Addressing systems, processes, and cultural challenges impacting theatre productivity.

Impact

✔️ Clinical Safety: The programme maintained clinical safety while increasing the number of cases handled.
✔️ Financial Benefits: The initiative generated additional income of £32,532, with a net cost-benefit of £4,488 after expenses.
✔️ Specialty Performance: Significant reductions in changeover times and increases in surgical activity were observed across various specialties, including ENT, Orthopaedics, and Gynaecology.

Click here to view more results.

Sustainable Solutions

By embedding HPLs as a standard business-as-usual practice, the Hub aims to create capacity for an additional 679 patients annually, generating over £1.5m in additional income. The Daily Situation Report (Sit Rep) developed during the programme provides real-time operational oversight, ensuring sustained improvements in theatre utilisation.

Conclusion

The Elective Hub’s collaboration with Prism Improvement and Four Eyes Insight has set a benchmark for surgical productivity. The successful implementation of HPLs and Firm Foundations has not only enhanced operational efficiency but also improved patient outcomes and financial performance.

View the PDF here for more information on the programme and a detailed look at the work undertaken.

Maximising Surgical Efficiency: The Impact of High Performance Lists

In a recent webinar hosted by Four Eyes Insight and Prism Improvement, experts Brian Wells, Samantha Sullivan, and Dr. Greg Cook, Clinical Director at Trafford Elective Hub discussed the transformative potential of High Performance Lists (HPLs) in surgical settings. With the increasing demand for surgical procedures, traditional methods of operating lists often fall short. HPLs present an innovative solution to enhance productivity without compromising patient care.

Understanding High-Performance Lists

High Performance Lists are designed to optimise surgical throughput by maximising the use of operating room time and resources. Unlike standard lists, which often see surgeons spending less than 50% of their time actively operating due to various delays, HPLs employ strategies such as double anaesthetic teams and parallel listing to significantly increase the number of procedures completed in a given timeframe.

Brian Wells, founder of Four Eyes Insight, emphasised that HPLs are not just about doing more cases; they are about doing them safely and efficiently. By overlapping processes and utilising resources effectively, surgical teams can reduce downtime and improve patient flow.

Key Strategies for Implementation

1. Super Lists: This approach involves using two anaesthetic teams to prepare the next patient while the current case is underway, allowing for a smoother transition between surgeries.

2. Parallel Listing: Running two operating theatres simultaneously with a single consultant surgeon can double the output, as seen in recent successful trials.

3. Enhanced Team Structure: Increasing the number of staff in the operating theatre, including anaesthetists and surgical practitioners, ensures that each case is managed efficiently, allowing for quicker turnarounds.

Results and Benefits

The results from implementing HPLs have been impressive. For instance, at Trafford, the average number of cases per session increased by 71% compared to traditional methods. Importantly, surgical times remained consistent, demonstrating that the quality of care was not compromised.

Dr. Greg Cook noted that the initiative has not only improved surgical throughput but has also positively impacted the overall performance metrics of the hospital, helping to meet targets for patient wait times.

Financial Implications

While there are costs associated with implementing HPLs, the financial benefits can be substantial. Increased patient throughput can generate significant additional income, making HPLs a financially viable option for healthcare institutions.

Conclusion

The webinar highlighted that High Performance Lists represent a promising avenue for healthcare providers looking to enhance surgical efficiency. By adopting innovative strategies and engaging clinical teams, hospitals can improve patient outcomes while addressing the growing demand for surgical services. As the healthcare landscape continues to evolve, embracing such models could be key to sustaining high-quality care in the face of increasing pressures.

For those interested in exploring HPLs further, contact us for additional discussions and insights.

Infographic: Impact of High-Performance Lists

An NHS Surgical Hub in North West England collaborated with Four Eyes Insight and Prism Improvement over 20 weeks to implement a successful Theatre Improvement Programme.

Part of the programme was to introduce High-Performance Lists (HPLs) that would optimise surgical productivity by refining workflows to overlap processes and minimising operational inefficiencies. Results are shown in the infographic below:

Why Is Data Integrity Vital for the NHS’s Future?

We all know that data is key to the NHS, especially with the need to reduce waiting times, but data only truly becomes King when it is reliable and accurate, which is why data integrity is vital to the future of the NHS.

Harvard Business School defines data integrity as “the accuracy, completeness, and quality of data as it’s maintained over time and across formats.”

1: Accuracy: Data must be correct and free from errors.
2: Completeness: All necessary data should be present and accounted for.
3: Consistency: Data should be uniform and consistent across different systems and formats

Maintaining data integrity involves various practices such as data validation, error checking, encryption, and access controls to protect data from unauthorised access and corruption.

Why is NHS data integrity important?

The significance of NHS data integrity lies in its impact on patient safety, healthcare outcomes, and the overall efficiency of health services. Accurate and reliable data is essential for informed decision-making, effective treatment planning, and the maintenance of public trust in the healthcare system.

Ensuring the NHS upholds high standards of data integrity is vital for effective decision-making and patient care, and it is critical to its future for multiple reasons:

✔️ Enhanced Patient Care: Reliable and precise data enables healthcare providers to make informed decisions regarding patient care. This results in improved diagnosis, treatment strategies, and overall patient outcomes.
✔️ Trust and Transparency: Upholding data integrity fosters trust between patients and healthcare providers. Patients must have assurance that their personal information is safeguarded and utilised correctly.
✔️ Efficient Resource Management: Accurate data enables the NHS to optimise resource allocation, thereby ensuring the effective and economical delivery of healthcare services.
✔️ Compliance and Legal Requirements: Maintaining data integrity is essential for the NHS to adhere to legal and regulatory standards, safeguarding patient privacy and mitigating potential legal risks.

What measures can be implemented to ensure the integrity of NHS data?

To enhance the effectiveness, trustworthiness, and innovation of the healthcare system, the NHS can maintain data integrity through several essential practices, including:

▪️ Regular audits that facilitate the identification and correction of inconsistencies, thereby ensuring the accuracy and reliability of data.
▪️ Data validation techniques employed to identify errors and inconsistencies, thereby ensuring the accuracy and completeness of data.
▪️ Ongoing training for staff on data protection and security practices is essential for sustaining a culture of data integrity.

In the past, The Health Foundation has advocated for the NHS to implement a sustained program addressing underlying barriers, alongside a closer alignment of initiatives aimed at enhancing data utilisation and transforming health and care services. Its five key areas of focus are still relevant in today’s NHS landscape [1]:

1: Improve underlying infrastructure for data and technology to provide high-quality, timely data for service improvement, research and innovation
2: Develop the analytical workforce and better harnessing their skills
3: Focus on data-driven innovation as a service, with routine development and deployment of open-source innovations developed in collaboration with end users
4: Build better implementation infrastructure accompanied by effective regulation, monitoring and evaluation to ensure safety and equity and to build confidence among healthcare professionals and the public
5: Foster a responsible approach to innovation to ensure everyone’s health care benefits.

The role of technology in providing assistance

Alongside best practices, technology and the advent of AI can assist the NHS in upholding high standards of data integrity.

A recent blog by Lee Scothern, Managing Director of Four Eyes Insight, emphasises the transformative potential of appropriate data in NHS operations. Scothern asserts that NHS boards must measure and comprehend performance through effective technology that facilitates easy, accessible, and representative data collection and analysis. This is particularly crucial as productivity remains a significant challenge for many organisations and continues to be a priority on the political agenda.

Comprehensive data, analytics, and reporting can guide NHS Trust boards in focusing on service delivery and its impact on patients, thereby improving decision-making and efficiency.

One example we have seen firsthand is how understanding data and utilisting intelligent software has helped one NHS Trust significantly increase operational visibility with a daily updated view of historical and projected performance within theatres. Not only did this improve the management and planning of hospital operations, it meant the Trust delivered 118 additional cases at a potential of £137k in benefit, ensuring patients could be seen quickly and safely.

In conclusion, the right technologies can assist the NHS to:

▪️ Utilise data from patient interactions to enhance services, gain a deeper understanding of health and care needs, innovate treatments, and foster advancements in data-driven technology and AI, resulting in more efficient and patient-centered care.
▪️ Implement frameworks that prioritise the collection, analysis, and learning from patient feedback, thereby enhancing care quality and ensuring that feedback from patients and service users informs improvement decisions.
▪️ Foster a culture of continuous improvement within the NHS to address unwarranted variations in care and enhance clinical leadership for improved outcomes.

The future of AI in the NHS

Examining the elective care pathway, particularly in the context of theatres, reveals numerous ways in which technology can enhance data integrity at a more detailed level. It can help to:

▪️ Explore and utilise latent data within EPR and PTL systems to identify specific opportunities for improving productivity via targeted funding for theatre capacity enhancement.
▪️ Identify and rectify unwarranted variations in surgical performance, including outlier procedure timings by anaesthetists and surgeons, to highlight avenues for improved safety and quality.
▪️ Establish automatic data integration with trust systems to enhance operational efficiency by minimising time duplication for coding and administrative teams.
▪️ Utilise AI to effectively schedule elective surgeries by leveraging local performance data to identify and optimise unused resources and capacity.
▪️ Substantially reduce the influence of interpersonal communication and behaviour on underperformance.

As the healthcare landscape evolves, the NHS must emphasise data integrity to address difficulties and enhance patient outcomes. The technology exists to facilitate it, but its efficacy is contingent upon the skill and knowledge of its users.

References

[1] NHS England » Information governance and data protection

5 Strategies for Optimising Outpatient Capacity

As of December 2024, Referral to Treatment (RTT) figures show that there are approximately 6.2 million patients waiting for treatment (7.4 million cases). NHS England reports that over 80% of all elective pathways conclude without patients needing hospital admission. Therefore, eliminating Outpatient backlogs is a critical enabler for NHS Trusts to achieve the targeted 72% of patients waiting no longer than 18 weeks for a first appointment by March 2026.

On a positive note, while the focus has historically been on theaters, the dial appears to be shifting. Over the last 12 months, we have seen a significant shift in energy to Outpatients improvement, demonstrating the NHS’s recognition of the pathway-wide benefits that can be achieved by optimising Outpatient processes, using patient-initiated follow-up (PIFU), and increasing remote monitoring through patient engagement portals (PEPs).

It is encouraging to see further focus on a move to handle elective care appointments via the NHS App. The target of 70% of all appointments being scheduled via the App is a significant step in modernising outpatient planning and patient communication routes.

With ongoing work through the GIRFT ‘Further Faster’ programme, options to help Trusts think differently about patient management in Outpatients are developing.

However, many of the aims and guidelines outlined in the national priorities are not new, such as enhanced Advice and Guidance implementation, 12 weekly validations for new appointments, increased usage of PIFU, and so on. While it is evident that these are the correct measures, the effectiveness of the guidance is dependent on their implementation.

How can Outpatient departments meet these targets?

The Outpatient service is vast. With so many improvement initiatives requiring distinct, speciality specific focus, making a tangible impact can feel like a mammoth and overwhelming task. However, some quick wins and important fundamentals can make a significant difference:

1: Know your capacity and demand

A robust understanding of expected demand streams and what resources you have to manage this can focus the mind on priority areas and bring everyone on the same page about the size of the gap that needs to be closed. Developing this baseline position and modelling the impact of various improvement opportunities helps teams visualise the art of the possible and think differently about the changes they could make.

2: Use what you have

Maximise the utilisation of your clinic slots. Direct your booking teams to vacant capacity ensuring the proper structures and digital tools are in place to fully re-book slots. Dig deeper into DNA rates to identify groups of patients, driving them and involve patients in solutions.

3: Maximise estate

Many clinic rooms sit unused, simply due to a lack of oversight. Implement governance processes to identify and reallocate these spaces to departments most in need.

4: Pilot new initiatives

With strong foundational practice in place, clinical and operational teams can feel confident in adopting more innovative changes to manage patients differently. Support champions to push ambition through the clinical body and demonstrate the art of the possible with well-planned pilots that can swiftly spread and scale into business-as-usual procedures.

5: Ensure the right resource is used

Empower specialist nurses, physician associates and allied health professionals to take on more responsibilities and free up consultant time for the most complex patients. You could also consider using chatbots and virtual assistants to answer common patient queries.

Although the Government has set out ambitious plans for the NHS and elective care in general, there is still a long way to go to achieve its targets. Working collaboratively, progress is being made, and its positive to see that in December alone, the NHS carried out 1.33 million treatments, up 6.5% on 1.25 million the year before.

We see on many of our programmes how hard NHS and Outpatient teams are working to care for patients and, like us, they understand that, at the end of the day, each one of the 7.4m cases is a person, not just a statistic.

Connect with Samantha Sullivan on LinkedIn.

Can NHS Trusts Meet Elective Care Targets?

Improving patient access to timely care and enhancing productivity are central to the NHS’s 2025/26 priorities and operational planning guidelines and in meeting elective care targets.

From an elective care perspective, one of the key targets is to have 65% of patients waiting no longer than 18 weeks for treatment by March 2026. We caught up with Four Eyes Insight Managing Director Lee Scothern to find out what this truly means for planned services and if it is achievable.

“Reducing the proportion of people waiting more than 52 weeks for treatment to less than 1% of the overall waiting list by March 2026, while also meeting a national objective of 65% for patients waiting no more than 18 weeks, is an ambitious but essential goal.

To improve patient care and restore public trust in our healthcare system, each trust must commit to at least a 5% improvement. Achieving this requires a slick, data-driven approach, partnered with an emphasis on collaboration across departments, NHS Trusts, and systems to enable strategic resource allocation and informed decision-making that can benefit flow and productivity.

An additional goal is to increase the percentage of patients receiving a first outpatient appointment within 18 weeks to 72% by March 2026. This objective demonstrates the NHS’s commitment to providing timely access to healthcare treatments. To make this possible, each trust must have a comprehensive understanding of clinic capacity—both slots and outpatient estate. Aligned with demand, this will help trusts understand the situation at hand and develop targeted improvement strategies to address it as part of their improvement process.

The NHS’s guidance also emphasises the adoption of emerging technologies, including AI and machine learning, to enhance patient care and operational efficiency. At Four Eyes Insight, we understand how crucial trust data is when trying to tackle the challenges of backlog clearance and optimise elective pathways. Utilising technology can help NHS Trusts to plan, align demand with capacity, highlight improvement trajectories, and achieve sustainable improvement and long-term cost savings.

Meeting these ambitious targets will require a concerted effort across trusts, underpinned by data, technology, and strategic planning. While the challenges are significant, with a structured and collaborative approach to capacity planning and process optimisation, these targets are achievable.”

What is a High-Performance List (HPL) and why is it important?

We collaborated with Prism Improvement to introduce High-Performance List (HPL) across theatre operations in an NHS Trust in the North West. What are HPLs, and why should Trusts consider implementing them for elective theatre activities?

A High-Performance List is a game-changing approach to theatre operations that emphasises rigorous preparation, teamwork, and increased resource efficiency to produce a highly productive, efficient list.

HPL is more than a plan; it represents a dedication to patient safety, excellent treatment, and achieving operational objectives that can be integrated into culture as a standard for excellence.

This handy infographic shows the benefits of HPLs:

If you’re interested in learning how High-Performance Lists can help your NHS organisation, contact us today!