Ear, Nose & Throat (ENT) and Ophthalmology Case Study in the Midlands
The Details
Risk of Missing Target
In December 2022, a total of 201 Ophthalmology patients were identified as part of the incomplete referral-to-treatment list exceeding 78 weeks that has to be achieved by March 2023, alongside 131 ENT patients. An additional 400 patients requiring pre-assessment had also built up due to clinic cancellations and staff shortages.
Lack of capacity
During the second half of 2022, the Trust made little, to no reduction in the number of 78 week waits. The waiting list for Ophthalmology was growing at a monthly compound rate of 9%, whilst the waiting list for ENT had been gradually decreasing at a monthly compound rate of 3%.
Collaboration
18 Week Support operational teams met with teams from the Trust to ensure we could quickly and safely mobilise a team of highly qualified clinicians to run the weekend clinics. Initially, we allocated two vacant outpatient rooms and theatres at the Trust’s two sites.
Full Pathway Solution
After the initial launch, we implemented a complete pathway model including outpatients, diagnostics, pre-assessment, and surgeries within 6 weeks (if referred).
Clinical Excellence
To accommodate a higher volume of patients, we modified our staffing model, allowing us to focus more on clinical outpatient activity. Working weekends and only using senior and experienced staff ensured that our elective activity was ringfenced from urgent care, leading to a highly efficient service.
Our Results
By March 2023, the Trust achieved a significant transformation in its waiting list and activity levels. From December 2022 to March 2023, the number of patients exceeding 78 weeks decreased by 98% across both ENT and Ophthalmology.
The 18 Week Support program saw 4,468 patients across the two services: 2,961 from Ophthalmology, 1,107 from ENT and the additional 400 that were still previously waiting for operative pre-assessment.
98%
Reduction of 78+ weeks waiting list
87%
Average utilisation rate
98.8%
Patient satisfaction score
Testimonial
Director of Operations, NHS TrustWe are delighted with the results achieved through our partnership with 18 Week Support. They helped us meet our performance targets and significantly enhanced patient satisfaction and staff morale.
Meet our Clinical Leadership Team
Ass. Prof. Mr Nish Mehta
Clinical Lead for ENTMr Nish Mehta graduated with double distinction in medicine and 1st Class Honours in Physiology from Guy’s, King’s and St Thomas’ Medical School and completed his advanced surgical training in leading London hospitals, including Great Ormond Street, St Bartholomew’s, Royal National ENT and Imperial Trust hospitals. He gained a fellowship from the Royal College of Surgeons and undertook further international surgical training in the USA, Netherlands and India. He was then selected to train to become one of the UK’s handful of hearing implant surgeons as part of the prestigious Graham Fraser Memorial Fellowship in Sydney, Australia. He is now a Consultant Otologist and Auditory Implant surgeon at the Royal National ENT Hospital, UCLH Trust with a joint appointment as Assoc Prof at UCL’s Ear Institute.
Mr Danny Mitry
Clinical Lead for OphthalmologyMr Danny Mitry is the Clinical Lead for Ophthalmology for 18 Week Support. Mr Danny Mitry is a leading Consultant Ophthalmic Surgeon based at the Royal Free Hospital in London. He has held several major research grants in support of his academic research. He’s been an invited speaker at international ophthalmic conferences and has been awarded several research awards for his work.
Private: Lisa Marie Jones
ENT & Neurology Lead NurseLisa is a Registered General Nurse and Non-Medical Prescriber with over 25-years’ experience in operating in the NHS and private healthcare settings. Lisa has a proven track record in transforming performance within healthcare organisations with a wealth of experience in participating in CQC and HMPPS inspections.
Lisa is a compassionate, formidable, and influential leader focused and driven to ensure the highest quality of care is delivered to patients. Lisa is passionate in delivering a culture of continuous learning, and providing educational opportunities to all healthcare professionals, enabling colleagues to reach their highest potential.
Khaled Alkarmi
Ophthalmology Lead NurseKhaled joined 18 Week Support as a Lead Nurse (Ophthalmology) since the inception of the company 2014. In a fast-changing healthcare practice and provision, his role is an ongoing process moving best practice forward for the benefits of patients. He leads by example, an inspiration to the wider multidisciplinary team and always contributes towards better patient experience and clinical outcomes.
Working as a Lead Nurse for Ophthalmology at 18 Week Support gave him the opportunity to push professional boundaries, thanks to the wealth and experience he has in the Ophthalmology field. He always demonstrates flexibility, punctuality, honesty, and an excellent work ethic in the delivery of patient care. His aim is to maintain and monitor high standards of care, recognise, and respond proactively to patients changing clinical needs in every clinical setting.
Reymar Apostol
Ophthalmology Lead NurseReymar started his nursing career in the General Emergency Department and moved to Ophthalmology where he has had a successful career for over 20 years. He has been in Senior Nursing roles for over 10 years. In his years in Ophthalmology, he developed knowledge and skills and gained his independent prescribing allowing him to see and manage patients independently. He has worked with 18WS since the inception of the company as an Ophthalmology Lead Nurse.
