Development of an Endoscopy Strategy for Northern Care Alliance

In March 2022 Northern Care Alliance (NCA) commissioned the NHS Transformation Unit to support the development of a trust-wide Endoscopy Strategy focusing on four main areas. The objective of the project was to support the delivery of a high quality and reliable service across the four NCA endoscopy units, aligning that with the wider work ongoing within Greater Manchester (GM).

The Challenge

In late 2021, the NCA recognised that they were experiencing several challenges across the service. These challenges included:

• An increased backlog of patients waiting for endoscopy procedures because of the restrictions enforced as part of the COVID-19 pandemic
• A significant reliance on insourced provision via private healthcare providers
• A reduction in capacity due to the transaction of one of their sites to another Trust
• Concerns that some Endoscopy estate would not meet Joint Advisory Group accreditation criteria

A need to realign workforce capacity against demand to account for the above challenges

The TU were commissioned to support the development of a trust-wide strategy which would address these challenges and adhere to their vision. The vision was to provide the highest quality Endoscopy services designed to meet the needs of the patients, in a timely way, that is cost effective and sustainable.

Our Approach

We understood what the difficulties and challenges were across the service on all 4 units by following the below stages:

• To refine the capacity and demand at each site by looking at existing and future estate options, substantive sessions, increased productivity and different procedure and patient requirements.
• To understand the clinical options for delivery by understanding the benefits and risks of each option and agreeing options for workforce and estates development.
• To develop an understanding of the people and operational elements of the service through an appraisal of estate and workforce proposals and financial implications, and an agreement of workforce and estates strategies.
• To produce a high-quality endoscopy strategy for the NCA that would address the previous phases.

Within each of these stages we engaged with key stakeholders across all four sites to develop an understanding of what the current picture was, and what the ideal endoscopy service would look like for each organisation. A key focus of engagement throughout the duration of the project was the Endoscopy Steering Group. This group was the central point of contact for the approval and endorsement of the strategy and would meet each month to monitor progress. We also engaged extensively with clinical, operational and nursing colleagues outside the steering group to ensure that we were capturing all aspects of the service and incorporating this into the development of the overall strategy. In addition, extensive capacity and demand, workforce and financial analysis was performed to give an-depth understanding of costs and productivity and identify areas and opportunities for improvement.

Following this approach we defined:

• Strategic Objectives: these articulated specific, measurable goals for Endoscopy that aligned with the organisations long-term vision.
• Strategic Drivers: these focused on ’what’ needed to change to meet the objectives.
• Drivers for change: these described ‘how’ each of the strategic drivers would be achieved by listing specific deliverables against each one.

The Outcome

We delivered a comprehensive Endoscopy strategy which was approved and endorsed through the Service Development Strategy Board and the Executive Management Committee. The strategy provided a variety of long term, medium term and short term outcomes and benefits on both the patients and the service, which the Trust acted upon following the end of our commission.