Following COVID-19, the delivery plan for tackling the backlog of elective care is focusing on four areas of operational delivery:
- increasing health service capacity
- prioritising diagnosis and treatment
- transforming the way we provide elective care
- and providing better information and support to patients.
This plan emphasises the importance of efficient ways of working that free up capacity and make the best possible use of staff skills, time and experience. National support programmes, such as Getting it Right First Time and Elective Care Improvement Support, are promoting such improvements across elective pathways.
Improvements will focus on some of the most common types, and highest volumes, of care including eye care and musculoskeletal services.
The scale of this task means that every minute counts. This is where Lean can help.
What is Lean?
We’ve written about Lean recently on the Q blog, and it’s worth revisiting this approach.
Lean originated in Japan’s automotive industry as a business methodology aimed at eliminating waste and increasing efficiency in the interests of value for customers. Lean aims to optimise processes for those who use and depend on them.
In health care, this means putting the patient at the centre of all activities and reducing or eliminating processing time that does not add value for the patient. The Lean ideal is to design processes that deliver patient value optimally without waste, delay or errors.
This is achieved through iterative application of Lean’s five operational principles:
- defining patient value
- mapping the patient journey (value-stream)
- making the patient journey (or value-stream) flow
- designing processes that ‘pull’ value towards patients as needed
- and pursuing perfection through ongoing continuous improvement.
Lean is an approach that could increase NHS capacity, freeing up clinical time and reducing avoidable delays.
Introducing Lean Online
Lean Online is a new programme of massive-open online courses (MOOCs) for anyone in health and social care who would like to learn about and apply Lean improvement concepts and tools. Learners of all levels are welcome, whether you are new to Lean, or have had some experience and want to develop your skills further.
The first programme of its kind for health and social care workers in the UK, all Lean Online courses are fully subsidised and CPD-accredited.
Lean Fundamentals, our entry level MOOC, introduces process improvement tools through a practical, structured, learning-in-action approach that can be applied immediately to deliver focussed improvement projects.
Lean has been used across the NHS to improve vaccination processes to increase throughput and recovery of a paediatric service waiting list.
Other areas of elective recovery focus that process improvement and Lean Fundamentals could support include:
- improving theatre time through streamlining turnaround processes (such as for non-complex cataract surgery)
- increasing outpatient clinic throughput (such as for intravitreal eye injections)
- maximising operation time (such as for hip and knee procedures)
The programme has been developed by NHS England and Improvement’s Improvement Capability Building & Delivery (ICBD) Group and by experienced Lean process improvement practitioners and technology-enhanced-learning experts. The course is made up of six one-hour modules over an eight-week period.
Participants can work through the modules at their own pace. They can interact with peers and expert faculty through the learning platform to maximise learning and enhance their ability to rapidly apply Lean process improvement tool and concepts in practice.
Date of upcoming course
The find out when the next Lean Fundamentals course will be running please visit www.qilearning.england.nhs.uk
You can also read more about how Iain has applied Lean improvement methodology to make service changes to improve productivity, clinician capacity and patient experience in a case study carried out in 2021.