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Improving utilisation of ringfenced elective care services

It has long been a GIRFT (Getting it Right First Time) recommendation to ring-fence elected beds whether for day surgery or for inpatients; or to have a stand-alone elective unit to provide the opportunity to protect those beds and use them more efficiently. Not only can this support the flow of patients through the elective pathways, but this also reduces the risk of post-operative infections as emergency medical patients that are routed elsewhere and can’t introduce infections onto what should typically be a ‘clean ward’. Early into the pandemic, this became challenging as wards were re-purposed to house Covid-19 patients with surgical and support staff within the NHS sometimes redeployed to support the Covid-19 response.

In October 2020, published data from the Royal College of Surgeons of England, in support of ‘protecting surgery through a second wave’ led to calls from surgeons to ring-fence hospital beds for planned operations. In some areas, the move towards this has been slow, this is due to the operational logistics and infrastructure updates required to bring about this change.

Subsequently, the long-awaited elective care recovery plan that was published in February 2022 outlined the need to create a new and extend existing surgical (or elective) hubs which would provide a clear separation between the urgent and elective care pathways, and also free up capacity to deliver high-volume, low-complexity (HVLC) surgery.

Despite fast tracking elective hubs,  with many already in operation, we are still seeing a significant number of breaches and under-utilisation within these ring-fenced services. This is often caused by the merging of elective and medical pathways to cope with higher acute demand which also exacerbates operational inefficiencies in the management of these hubs as the ring-fenced beds no longer stay ring-fenced.

How Four Eyes Insight can support

As providers continue to work toward elective recovery, Four Eyes Insight are here to help. We use the combined power of people, data and technology to get to the root cause of NHS elective care pathway inefficiencies; working collaboratively and engaging with all stakeholders to get buy in for change from the ground up. We implement interventions that optimise elective care pathways and provide tools to monitor their effectiveness ensuring that a culture of continuous improvement to drive long term, sustainable change is embedded along the way.

If you would like to find out more or discuss your requirements, please email