In 2017 the Cheshire and Merseyside Cancer Alliance prioritised endoscopy as an area for improvement in accelerating cancer diagnostic pathways. St Helens and Knowsley Teaching Hospitals (STHK) were interested in taking forward work to improve efficiency and was commissioned to host an endoscopy improvement project.
As part of this project a review was commissioned which highlighted the challenges posed to monitoring productivity by inconsistent data collection.
Clinicians from STHK worked with an IT platform provider to develop a tool to monitor endoscopy unit usage and help staff manage patient lists. The cloud-based tool, called Thrive, holds non-identifiable patient data and produces reports that help inform approaches to improve efficiency.
The tool uses the British Society of Gastroenterology (BSG) points system which assesses the time needed for a particular procedure. This allows greater understanding of the nuances about the impact of procedure complexity on waiting times, and an understanding of how the composition of a waiting list impacts the clinical skills and experience required to manage patients. This ensures that service quality and equality of access remain central to managing endoscopy lists.
The Cancer Alliance provided funding for initial development of the tool. Once it had been trialled and the potential for adoption established, further funding was provided to the Cheshire and Merseyside Endoscopy Network to support its spread into other trusts.
The Innovation Agency supported this innovation with commercial expertise and funding for a real-world evaluation.
Adoption and spread or improvement methodology
The Cheshire and Merseyside Cancer Alliance identified endoscopy as a priority area for improvement. St Helens and Knowsley Teaching Hospitals (STHK) was then commissioned to host an endoscopy improvement project.
A review was commissioned that highlighted the challenges that inconsistent data collection posed to monitoring productivity. STHK clinicians worked with an IT specialist to develop a tool to monitor endoscopy unit usage.
The Cancer Alliance funded early development of the tool and, following its trial, more funding was given to the local endoscopy network to help spread it to more trusts. The Innovation Agency funded an evaluation to support its adoption and spread.
Regular meetings of endoscopy units where Thrive has been deployed help improve efficiency, while QI methods are used to establish if improvements have been made.
The Cancer Alliance and the local network formed a recovery team to tackle pandemic demand imbalances. Thrive has been adopted in most units and the remainder are expected to sign up.
The Endoscopy Network has become a highly effective group of clinicians and managers who are leading an ambitious transformational programme.