A big and daunting challenge:

The crisis facing the NHS is not just the sheer length of the waiting lists across all surgical treatments and the time and cost required to clear it, but the impact on the health and lives of those waiting for surgery. A recent CQC Survey Report² showed that “41% of elective patients said their health deteriorated while waiting to be admitted to hospital, though 51% said their health remained the same.” Whilst patients are on these waiting lists their health and quality of life are at risk of deteriorating. This is partly because many patients who are waiting for elective surgery are 65+ and this population tend to have a higher rate of comorbidities such as diabetes and hypertension.³

The current waiting list patient journey is not designed for lists to reach this length of time. But no single organisation, department or team within the NHS has proactive care responsibility for patients who are deteriorating whilst waiting.

The knight in shining software?

Digital health is a broad term but, in its essence, it is using digital technologies and data to improve people’s health and healthcare. But with such a widespread people-reliant crisis, how can digital health help make even a dent?

Behaviour change apps

Many people who are on elective surgery waiting lists health is deteriorating as they are suffering from co-morbidities such as diabetes, hypertension, as well as disease-related anxiety and depression. Unhealthy patients mean that surgery can be riskier, hospital stays extended and recovery times longer. There are existing perioperative and prehab programmes to help prepare patients for upcoming surgery however these usually only begin a month or two before the surgery, whereas patients now can wait for surgery for over a year, so these programmes happen too late in the patient journey. Improving people’s health and lifestyle habits by offering tailored digital support to patients can help solve these challenges.

Engaging and gamified digital health apps can provide patients with the ability to set goals, track symptoms and undertake regular assessments to activate patients and provide clinicians and caregivers with better insight into when a patient’s health is deteriorating ahead of surgery.

Remote Monitoring and Wearables

Through active and passive tracking via smartphones, wearables and apps patients are more informed about their health status. Healthcare providers can remotely track patients’ vital signs, offering a proactive approach to identifying potential issues whilst on waiting lists before they escalate. Remote monitoring could also allow clinicians to have a more informed discussion with patients about whether surgery is the right option in the first place, helping them better weigh up BRAN (benefits, risks, alternatives and what happens if we do nothing).

Digitised Clinical workflows

Digitised clinical workflows which integrate with electronic health records, laboratory information management systems and appointment management systems allow for more efficient management of patients. Nurses and doctors have greater oversight into where a patient is on the clinical pathway to avoid patients falling through the gaps. Patients whilst on waiting lists can from the comfort of their homes respond to PROMs and other useful questionnaires, view test results, receive reminders and seamlessly schedule, reschedule, or cancel appointments through user-friendly digital platforms. This not only minimises no-shows for surgical appointments but also improves the utilisation of healthcare resources, allowing hospital staff to efficiently plan and executive operating lists.

AI-assisted Prioritisation

Artificial Intelligence (AI) offers a sophisticated solution to the intricate task of triaging and prioritising patients. AI-driven systems can analyse patient data provided by apps, workflows and databases with unparalleled speed and accuracy. AI solutions could assist exhausted and overwhelmed clinicians in triaging patients right at the start when deciding about surgery. AI can also be used to help prioritise waiting list cases by considering the patient’s condition, any comorbidities and potential health inequalities. By enhancing decision-making processes, AI holds the potential to support patient triaging, and clinical prioritisation programmes to better prioritise waiting lists based on clinical urgency

AI-Predictive analytics

Taking a longer-term view AI-driven predictive analytics can be used to anticipate future healthcare trends. The integration of AI-driven predictive analytics is a visionary approach to healthcare management. By analysing historical data, these algorithms forecast trends, enabling healthcare providers to proactively prepare for surges in patient volumes. Predictive analytics thus becomes an invaluable tool for planning resource allocation and mitigating future potential surgery bottlenecks.

Digital health to deliver a fairy-tale ending?

As the NHS grapples with the waiting list crisis, integrating digital health solutions emerges as a beacon of hope. Behaviour change apps, remote monitoring, digitised clinical workflows, AI-assisted prioritisation and predictive analytics provide alternative ways to reduce the waiting list crisis rather than just increasing the number of operations offered. Embracing this digital healthcare strategy is not merely a response to a crisis; it’s a strategic step towards a future-ready NHS ecosystem that prioritises accessibility, efficiency, and, above all, the wellbeing of patients.

Bio

Jamie Campbell is the associate director of Commercial Partnerships at Avegen. Avegen is a digital health platform company based in London. Our core product, HealthMachine®, is a digital health platform consisting of a robust set of tested building blocks which allow us to create innovative digital health solutions for patients and clinicians at speed and scale, without cutting corners.

Avegen now works with major pharma, research institutes and healthcare providers around the world and their products touch 2  million + patients managing long-term conditions in infectious diseases, cardiovascular & metabolics, oncology, endocrinology, mental health and maternal health. Please get in touch to learn more.

References:

1. https://www.health.org.uk/news-and-comment/news/nhs-waiting-list-to-peak-at-more-than-8-million-by-summer-2024#:~:text=New%20analysis%20by%20the%20Health,whether%20NHS%20industrial%20action%20continues.
2. https://www.cqc.org.uk/publications/surveys/adult-inpatient-survey
3. https://doi.org/10.1136/bmj.p162

The original article was published on MedHealthOutlook - https://medhealthoutlook.com/the-nhs-waiting-list-crisis-and-how-digital-health-can-help-solve-it/