Scheduling department
The SWLEOC Scheduling Team are responsible for scheduling for all surgeons represented across the Partnership. There are currently 52 surgeons including visiting surgeons and SWLEOC academic surgeons.
The SWLEOC scheduling team is split into two teams, the admin hub and the scheduling team.
- adding patient waiting lists onto IPM & Bluespier;
- contacting the patient and creating an online healthcare questionnaire on Lifebox;
- once the patient has completed Lifebox, the team will book patients in for a virtual pre-assessment, and a physical pre- assessment if required (if a patient has not been one stopped).
- liaising with and maintaining consultants waiting lists;
- booking patients in for surgery, in chronological order and according to a set of booking rules;
- ensuring theatre lists are fully utilised;
- book any patients that require an anaesthetic review and/or an Echo;
- remove patients from the waiting list and discharge back to the care of the GP;
- re-instating patients back onto the waiting list;
- booking interpreters for theatre lists.
- Receive referral from outpatients or Partnering trusts;
- add referral to IPM and Bluespier;
- make initial contact with patient and add to Lifebox;
- once Lifebox has been completed, the admin hub team member will book a virtual and physical assessment with the patient;
- the patient will be offered a surgical date by the scheduling team. The scheduling team work very closely with the POA team so that majority of patients only receive their surgical date once they are medically and socially fit to proceed with surgery. The scheduler will also offer a COVID-19 swab appointment if required (this is deemed by the nurses triaging a patient at the time of the virtual pre assessment);
- the scheduler will liaise with their consultants to establish which patients are suitable for their list;
- the critical steps for the team, are to book in accordance with the ABC policy and the 18-week referral to treatment time pathway.
The scheduling service was established the day SWLEOC opened in 2004. The team originally started with 2 members of staff, this has expanded over the years to 14 schedulers, 7 staff in the admin hub, a manager and a supervisor. There are over 52 surgeons, from various base trusts, operating at SWLEOC, which the team schedule for, and around 2,000 patients on the waiting list. The scheduling department merged with Epsom and St Helier’s Trauma and Orthopaedic department in November 2020. With the increased workload, the admin hub was created in June 2022 to help alleviate pressures in several key areas at SWLEOC.
The teams interact with the following departments:
- Pre-operative assessment nurses;
- Outpatients;
- Medical records;
- Pre theatre / Post Anaesthetic Care Unit;
- Transport;
- Performance team;
- Base trust Patient Pathway Co-ordinators;
- Theatres;
- Consultants:
- GPs.
The scheduling team are located on the 2nd floor Woodcote wing adjacent to the Centre, whilst the admin hub is located offsite at a different building, Gateway.
- Bluespier;
- IPM;
- Lifebox;
- PACS;
- Clinical Manager;
- NHS Spine.
- Referrals being added to the system within 48 hours;
- creating the online account on Lifebox for patients to complete in preparation for surgery;
- high volume of patients allocated to each Scheduler due to increasing demand of patients requiring surgery;
- short notice cancellations due to COVID-19;
- capacity and demand mismatch, for example having surgeons who have regular theatre lists but due to the number of patients on their waiting list, the theatre lists may not be fully utilised. Conversely, based on a surgeon’s job plan they may have many patients on their waiting list but not enough allocated theatre lists.
- A merge of two teams together to create the administration hub;
- moved theatre lists around within the team, to spread the workload out evenly;
- the Scheduling manager works closely with the outpatient manager. The team have been looking at adjusting theatre lists and asking consultant to carry out a clinic instead, or vice versa. This ensures theatre capacity is used to its full potential by offering the list to a consultant with a large waiting list, and for the consultant in clinic to increase their waiting list.
With taking over the Trust Trauma and Orthopaedic team and workload, the Centre inherited a large waiting list, exacerbated by the COVID-19 backlog. With the merge, the trust staff no longer book any outpatient appointments, and their job role focusses solely on scheduling. This enabled them to focus on scheduling their long waits, and to fully utilise theatre capacity.
With the newly created administration hub, there are a number of patients on the digital pre-operative assessment platform, Lifebox, that need to be validated.
- Working and adhering to the 18-week pathway. Waiting lists are still compounded by the COVID-19 backlog, causing delays to the patient pathway.
- Working in a partnership can be challenging when surgeons are required more in theatres to help alleviate their long waiting patients and to help reduce the length of their waiting list, but as they work for their base trust, they are not able to cancel commitments at base to offer more theatre time.
- As POA is digital, it can be time consuming contacting patients to encourage completion within the allocated time and ensure that patients that are not able to complete this digitally are identified appropriately.
- Having multiple IT systems due to lack of one integrated system and electronic health record leads to duplication of work and potential data quality issues.
- Robust and regular communication;
- teamwork and workforce resilience;
- professionalism;
- patient first;
- collaborative working.
Merging SWLEOC and the trust Trauma and Orthopaedics resulted in a huge increase in the number of patients that the team were responsible for, and six new members of staff needed to adjust to the way SWLEOC works and schedules. Despite this, it was beneficial for patients to be managed by a dedicated, central team.
Creating the admin hub has been a great help to alleviate workload and pressures from the scheduling team. This process has enabled the patients to be booked in for pre-assessments sooner, which helps alleviate pressure from the nurses, as there is a longer space between appointments and surgery date.
There was no handover period when taking over the Trust Orthopaedic pathway. The trust schedulers that moved to work within the SWLEOC team, needed to adjust to the SWLEOC way of working at the same time as training the SWLEOC staff on how to schedule lists in the Trust main theatre and day case unit.
Creating the administration hub has provided the team with increased support and the ability to carry out timely patient validation.
- We are a team that works well together, and it is important to embed collaborative working within the team culture.
- Communication and transparency are key, especially working with the Centre partner Trusts.
- Having a unique admin hub team to tackle several areas in patient’s pathway has had a huge impact in tackling wait times and relieving pressures in the start of the patient’s surgical journey.
Staff
Staff Member: Scheduling Manager (Band 7 x 1 WTE)
Role:
The scheduling manager is responsible for ensuring the smooth running of the Scheduling Department and providing leadership to the scheduling team. The scheduling manager ensures integration across the departments and attends departmental meetings, including performance and cancellation meetings.
Staff member’s other roles in the centre:
- supervision;
- appraisals;
- service evaluation and;
- audits
Staff Member: Scheduling Team Supervisor (Band 5 x 1 WTE)
Role:
To manage the Administration Hub to ensure patients are promptly added to Lifebox and booked a pre-operative assessment appointment, ready for the Scheduling team to book the surgery date. Managing referrals from external partner Trusts and internal SWLEOC Consultant referrals.
Staff member’s other roles in the centre:
Liaising with POA and adjusting clinic capacity based on demand. General Team Management of the Admin hub team members
Staff Member: Patient Co-ordinators (Band 4 x 12 WTE)
- 7 x Schedulers at 37.5hours per week;
- 5 x Schedulers at 30 hours per week;
- 1 x Scheduler at 21 hours per week;
- 1 x Scheduler at 19 hours per week.
What this staff member does in relation to this activity:
Schedulers book operations in discussion with the patient and liaise with Nurses and Consultants.
Staff Member: Administration Support (Band 3 x 8 WTE)
Role:
Hub team members book LIFEBOX appointments, POA appointments and add referrals to both systems.