21st January 2025
Cheshire and Merseyside Cancer Alliance (CMCA) commissioned the NHS Transformation Unit (TU) to deliver two products to help with the challenges they were facing in their current hysteroscopy pathway. The TU’s task was to deliver two key solutions: a toolkit for pathway redesign applicable across multiple cancer pathways, and a simulation modelling tool to assess staffing and capacity needs in anticipation of future demand. Both solutions emphasised workforce skills and competencies, addressing critical challenges faced by CMCA due to increased service pressures.
The Challenge
In 2023, CMCA recognised that they were experiencing challenges creating a model to redesign their current hysteroscopy pathway and the associated workforce. Their drivers were:
- The need for CMCA to implement a single, unified pathway at Liverpool Women’s NHS Foundation Trust (LWFT).
- A requirement for a systematic redesign model applicable to the hysteroscopy pathway including workforce planning.
- A need to understand what capacity CMCA would need if demand increased within the current hysteroscopy pathway.
The TU were commissioned to support the development of a clinical redesign strategy which would address these challenges and allow CMCA to trail a pathway mapping toolkit to improve their hysteroscopy pathway.
Our Approach
The TU worked collaboratively with and alongside local leaders and stakeholders to develop a toolkit for pathway redesign to help refine their hysteroscopy pathway. Our work considered and responded to local challenges to produce an appropriately tailored solution that CMCA could utilise and implement independently.
This included:
Pathway Redesign Process: We used a structured methodology to evaluate pathways, assess workforce challenges, and identify areas for enhancement and improvement.
Stakeholder Workshops: We held two workshops where we engaged with multiple stakeholders to collaboratively design and co-produce the redesigned pathway, which directly informed the toolkit’s development.
In addition to the pathway redesign process, CMCA were looking for support to develop a tool to project future activity and the resources they would require. Therefore, a simulation modelling tool was developed alongside this pathway.
- The graphic shows the process we developed. We used a quality improvement approach to review CMCA’s current hysteroscopy pathway, understand workforce challenges, and identify where improvements could be made.
The Outcome
As a result of this collaboration, we produced:
- A comprehensive toolkit to support CMCA to review, refine, and develop future pathways. CMCA have now put this toolkit to use and have implemented their new hysteroscopy pathway.
- A newly developed cancer pathway for LWFT.
- A simulation modelling tool to project and prepare for future workforce and capacity demands which CMCA used to create their new hysteroscopy pathway.
The redesigned pathway and toolkit developed collaboratively by the TU and CMCA, helped CMCA to refine their hysteroscopy pathway to improve their hysteroscopy diagnostic services. This led to an increased percentage of patients receiving timely diagnosis.
“The pathway mapping workshop which took place at Liverpool Women’s Hospital was delivered well and there was excellent engagement with many stakeholders beforehand to make sure a variety of teams and roles were represented. The team were also good at communicating progress with us including updates on conversations with stakeholders, this helped support other work and was much appreciated.”
Jennifer Burgess, Senior Project Manager, Cheshire and Merseyside Cancer Alliance