Therapists at Ascot’s Heatherwood Hospital, part of Frimley Health NHS Foundation Trust, have been able to help 14 per cent more patients per month prepare for surgery with an innovative digital waiting list tool.

Following the trial of a new digitally-led approach, the therapy team at Frimley Health NHS Foundation Trust is now able to identify and prioritise elective hip and knee replacement patients. The therapy team plays a crucial role in preparing patients for surgery, with their support facilitating earlier recovery, safe discharge, and minimising surgery cancellations and postponements.

The project, which ran from January to June 2024, and is now fully embedded at Heatherwood Hospital. Created by Graphnet Health, the tool is part of the Combined Intelligence for Population Health Action (CIPHA) population health platform and integrated into Connected Care, the Frimley Health and Care Integrated Care System (ICS) shared care record.

Before the introduction of this tool, therapists did not have access to the details of patients until the date of their nurse surgical pre-assessment appointment at hospital. Now, clinicians can use the tool to identify which patients will require therapy intervention prior to surgery.

There have been significant improvements in a number of areas, benefiting both patients and the hospital. Patients enjoy an extended preparation period, from their pre-assessment date to their surgery date, allowing them time to engage in prehab exercises, diet improvements, preparing their home and organising support for carers. During the pilot, 125 additional patients were pre-assessed with only 10 patients receiving less than six weeks’ notice.

The demand on hospital staff has also been reduced, due to increased use of virtual pre-assessments. Patients must still attend their nurse surgical pre-assessment appointment, to discuss the plan for their surgery. However, they do not need to see the therapist face-to-face if they have already been contacted virtually. This saves the patient time in their pre-assessment appointment and reduces pressure and the number of patients for the therapist in their clinic. This allows the therapist to focus and spend more time with the complex patients.

Emma Sheppard, Pre-assessment Occupational Therapist at Heatherwood Hospital, and Project Lead, explained that eligible knee and hip replacement patients who use the waiting list are contacted and can choose to have their preassessment conducted via the phone or see us at the face-to-face surgical pre-assessment meeting, with most patient opting for the remote option.

“Patients that have the MyFrimleyHealth Record are sent a link to the Frimley Orthopaedic website where they can find all the information that has been discussed with them virtual. This includes prehab exercise videos, preparing for surgery information and links to other useful organisations, such as the Royal College of Anaesthetics. We’ve had some very positive feedback from patients so far. They feel like they’re not just sat on a waiting list. They have had contact from a real person, and the support and advice mean they’re getting on with their exercises and other important prehab preparation weeks earlier.”

– Emma Sheppard, Pre-assessment Occupational Therapist at Heatherwood Hospital, and Project Lead

Along with other benefits, the digital tool has helped the team identify eight people that needed to be removed from the waiting list, as they weren’t medically fit for surgery, or it had been completed elsewhere. The aim now is to continue using the waiting list tool to identify and support elective orthopaedic patients, and to grow the use of virtual therapy pre-assessments. The goal is for 30 per cent of patients to be virtually assessed by the therapies team by 2025, and 50 per cent by 2026. There are also hopes that Heatherwood Hospital’s success will see the approach rolled out in other sites across Frimley ICS within the coming months.

Frimley is part of the collaborative CIPHA (Combined Intelligence for Population Health Action) programme, an 11 ICS supplier supported consortium covering 17m patients. Members work together to develop, trial and deploy major transformation initiatives based on data from patients’ digital health records.