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%.


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.

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Reduction of 78+ weeks waiting list


Average utilisation rate


Patient satisfaction score

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