Dermatology 2WW insourcing project

The challenge

In September 2020, the Trust’s dermatology team approached Agile due to a combination of staffing issues, maternity leave in a small team and the pandemic. The Trust had a surgical list that needed reducing and wanted to bring the 2WW down to under a week.

The solution

They had spare capacity on a Friday, Monday and weekends. A poor experience with a previous insourcing provider had left the Trust, understandably keen to ensure any new provider could provide an excellent level of service.
Early on, Agile introduced their Specialist Clinical Advisor, who had a wealth of NHS/private and insourcing experience. The SCA worked with the Clinical Lead, the Service Management and the Agile team, to create a solution that would quickly reduce both the 2WW and surgical backlog. CV’s were approved by both the SCA and the Agile Medical Director and all candidates underwent an interview. The Medical Director provided clinical support to the team throughout the contract, which provided reassurance to the Trust.

Implementation began and Agile put in place an experienced team of dermatology consultants and dermatology nurses, as well as HCAs and a medical secretary, experienced in dermatology, plus a receptionist. At the request of the Trust, Agile employed a member of their nursing team for governance and continuity purposes. After the team received relevant training induction and the governance was put in place, the project started. The SCA joined the weekly MDT meeting and represented Agile in reviewing results, writing letters, making referrals, requesting follow-up appointments for treatment, or delivering difficult news etc.

Agile has weekly calls with the Service Management team and monthly review meetings to monitor KPIs and ensure the service is operating to the Trust’s exact specification and for best patient service. When needed, clinical meetings also take place between the Clinical Lead and Specialist Clinical Advisor.

Adapting for COVID

As a result of COVID-19, Agile moved to a reduced service in January, but went back to normal at the end of March. The service has changed again to consultant only – providing mid-week cover for a peak in demand and a dip in substantive availability due to holiday/isolation etc. Agile has a truly flexible approach to meeting the Trust’s needs.

The team were very happy with this arrangement, as it provided continuity between weekday and weekend teams.

The results

The main weekend team saw huge volumes of 2WW patients, and, with two consultants, they could see and treat every patient that needed to be treated:

• To date the Agile team has seen and treated over 3,000 patients to contract end March 2022. The team also covered surgery on Friday’s and Monday’s, bringing the surgical list down to the lowest it’s ever been.

• The team also covered surgery on Fridays and Mondays - bringing the surgical list down to the lowest it had ever been.

• Patient feedback is incredibly high, 98% very good and good.

• The Agile team are on-call 7 days a week to resolve any issues - usually IT related, but anything from too many patients turning up to not enough.

Testimonials

Our experience of Agile was very positive; there were very good communications with the clinical nd management team throughout the whole process. The lead clinician took real ownership of the clinical caseload that the Agile team were helping us with, and we had confidence that the patients were being looked after very well. The positive patient feedback we received was testament to this.

Dr Jonathan Batchelor - Dermatology Clinical Lead, Beckenham Beacon

Agile have provided an excellent service throughout. Both the clinical and management teams have always been available to help resolve queries in a timely manner.

Demi Cullum - Assistant Service Manager, Dermatology, Diabetes and Endocrinology