Ear, Nose & Throat (ENT) Case Study in the Midlands

The Details

Risk of Missing Target

In December 2022, a total of 130 patients were identified as part of the incomplete referral-to-treatment list exceeding 78 weeks that has to be achieved by March 2023, alongside 623 patients on the list exceeding 52 weeks.

Lack of capacity

During the second half of 2022, the Trust only made a small reduction in the number of 78ww from 145 to 131. Consequently, the Trust opted to seek assistance from 18 Week Support in tackling the backlog.


18 Week Support operational teams and our clinical lead Mr Nish Mehta met with teams from the Trust. Initially, we allocated two clinic rooms each day on Saturdays and Sundays, primarily for outpatient appointments.

Full Pathway Solution

After the initial launch, we implemented a complete pathway model, wherein patients assessed by our team and determined to require surgical intervention were subsequently scheduled for treatment by the 18 Week Support program and underwent surgery accordingly. To meet the required activity levels we ran 4 rooms over the weekend.

Clinical Excellence

On each list we maximised both clinical excellence and the number of patients who could be safely treated.

Our Results

By March 2023, the Trust achieved a significant transformation in its waiting list and activity levels. The backlog of patients waiting over 78 weeks was eradicated by March 31st. From December 2022 to March 2023, the number of patients exceeding 78 weeks decreased by 98%, from 131 to only 2.

The 18 Week Support program conducted 31 lists and treated a total of 1,239 patients. We were able to achieve this through an increase in clinic utilisation, an average of 96% compared to the Trust average of 82%.

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Reduction of 78+ weeks waiting list


Average clinic’s utilisation


Patient satisfaction score

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