NHS0016

 

Written evidence submitted by Remedy Healthcare Solutions

 

INTRODUCTION TO REMEDY HEALTHCARE SOLUTIONS

  1. This is a submission by Remedy Healthcare Solutions (Remedy) to the Public Accounts Select Committee of the House of Commons’ Inquiry into managing NHS backlogs and waiting times.

 

  1. Remedy is a CQC registered diagnostics and screening provider and the UK’s fastest growing provider of clinical services to the NHS.

 

  1. We are encouraged by the increased focus on the elective care backlog across government and warmly welcome this timely inquiry into managing NHS backlogs and waiting times. We are fully committed to helping government implement its recovery plans across elective care, including by embracing innovative solutions in partnership with the independent sector, though we firmly believe that this needs to be accelerated to meet the soaring demand. 

 

  1. As a proud and committed partner to the NHS with over 50 years of combined experience across our team of experts, we provide end-to-end modular healthcare solutions with fully staffed one and two room endoscopy units that come ready to use, insourcing our own highly trained and highly skilled staff to operate the facilities.

 

  1. Alongside the provision and staffing of high-quality, sustainable, and cost-effective modular healthcare units, Remedy’s specialisms include endoscopy, gastroenterology, teleradiology, urology, ENT, ophthalmology, rheumatology, and dermatology.

 

  1. Remedy fully recognises the ways in which Covid-19 has compounded existing pressures on the NHS, as well as the challenges related to workforce recruitment, training and retention are having on the delivery of excellent patient care.

 

  1. Founded in 2016, Remedy has first-hand experience of responding quickly to the urgent challenges facing the NHS. Our first modular facility went live in 2021 in Cumbria and is operational 5 days a week.

 

  1. Remedy understands the need to futureproof healthcare facilities and adapt quickly to changing public health needs. Through delivering our modular units, we are able to prioritise flexibility and ensure we are delivering the highest quality services in communities across the country.

 

BACKGROUND

  1. As of September 2022, over 7 million people in the UK are on a waiting list for NHS treatment[1], with the average waiting time of approximately 14 weeks for treatment. This figure is likely to be higher, given the number of patients on the so-called ‘hidden backlog’ who need care but whose referrals have been cancelled or who have not come forward for treatment, is rising.[2]

 

  1. There are fewer diagnostic facilities in UK hospitals than in any other comparable health system. The UK has only 9 CT scanners per 1 million people, while the average number in OECD EU nations is 19. Similarly, there are 11.5 MRI scanners per one million people in OECD EU countries, against 7.7 in the UK.[3]

 

  1. These problems have been exacerbated by the fact that there are fewer hospital beds in the UK than in almost any other developed economy.[4]

 

  1. The Covid-19 pandemic demanded significant levels of staffing and resources to support the immediate pandemic response, putting unparalleled strain on an already overburdened healthcare system.

 

  1. While there is a clear desire to make good progress on reducing the backlog, this has sometimes resulted in patients with more complex conditions having to wait longer for access to certain treatments as inclusion criteria can be restrictive.

 

  1. At the same time, more people are living longer as a result of successful efforts to improve life expectancy[5], carrying with them a host of age-related diseases. A continuing lack of diagnostics capacity will result in a rising proportion of people needing to wait longer for diagnostic tests or operations. There were over one million people on diagnostics waiting lists in January 2020 twice as many as the number a decade earlier.[6]

 

  1. Workforce recruitment, training and retention is one of the biggest challenges facing the NHS today. Long-term issues including excessive workloads, fatigue and the chronic problem of unfilled vacancies have been aggravated by the Covid-19 pandemic, putting increasing pressure on existing personnel.[7]

 

  1. Insourcing agencies have acted as an important support network to the NHS by providing the vital staff needed to deliver excellent patient care. However, as workforce pressures have intensified and Trusts become more in need of solutions, insourcing standards have begun to deteriorate.[8] This quick-fix approach does not support the development of long-term solutions to the workforce crisis.

 

THE DESIGN OF NATIONAL RECOVERY PLANS

  1. As the NHS has itself observed, addressing the elective care backlog alongside meeting existing (and rising) demand in primary and community care, as well as for mental health services, will take several years.[9]

 

  1. The British Medical Association (BMA) has implored the Government to take more urgent action against rising waiting lists and to minimise pressures on hospitals.[10]

 

  1. In April 2022, the Government announced that it would deliver 160 Community Diagnostic Centres across the country by 2025.[11] This is a transformational step forward that will enable communities to access vital care.

 

  1. In its strategy for tackling the Covid-19 backlog of elective care published in February 2022, NHS England laid out four areas of delivery on which it pledged to focus.[12] They are:

 

  1. The independent sector provided a significant degree of extra capacity throughout the course of the Covid-19 pandemic, making sure that patients were still able to access the services they required, even as occupancy rates reached unprecedented levels. The NHS has said that securing sustainable partnerships with providers in the independent sector will be critical to the provision of timely and high-quality patient care.[13]

 

IMPLEMENTATION OF THE RECOVERY PLANS, INCLUDING THE USE OF INDEPENDENT SECTOR PROVIDERS

 

  1. Community Diagnostic Centres (CDCs) have a central role to play in tackling the backlog in elective care and Remedy’s bespoke and flexible modular units represent an example of the innovative solutions available that have the capability to deliver positive patient outcomes in line with NHS ambitions.

 

  1. Delivered at a significantly faster rate than brick and mortar facilities, modular units are able to meet the urgent requirements of the contemporary health sector without compromising standards at any stage. Modular units can also be constructed away from main hospital buildings on almost any type of land site, opening a breadth of options to the health sector and enabling unconventional solutions to capacity expansion to be identified.

 

  1. Modular units are able to be repurposed and relocated, depending on demand. This enables a greater concentration of modular facilities to be rapidly constructed in areas across the country that have the highest levels of demand. This has become particularly pertinent in the aftermath of the Covid-19 pandemic which saw certain regions of the country hit with higher case numbers, resulting in considerable strain on health services and lengthier waits for elective care.

 

  1. Remedy’s mobile and modular healthcare capabilities relieve pressures on surgeries and hospitals, providing dedicated facilities for diagnostics and treatment and helping to drive prevention and early detection in diagnostic services.

 

  1. The adaptability afforded by Remedy’s modular solutions allows CDCs to be delivered in the heart of the communities they serve and bringing life back into once neglected community spaces.

 

  1. Remedy understands the problems around workforce recruitment and retention and is committed to providing tailored insourcing solutions that meet the individual staffing news of Trusts. We are dedicated to training all the staff we insource, enabling the seamless integration of staff into the facility, helping to reduce the burden on Trusts to provide this training themselves.

 

  1. Our recruitment team prioritises selecting the highest quality staff that are local to the facilities in order to minimise the amount of time spent travelling to and from the modular units. Travel time can be a significant drain on a staff’s working week and incurs additional costs. In the context of a cost-of-living and fuel price crisis, our solutions seek to minimise these impacts for insourced staff, making it as easy as possible to access our sites.

 

  1. Insourcing our own staff enables us to quality assure our facilities and ensure that they are completely operational once constructed. This aspect of Remedy’s offering works to reduce inefficiencies in the management of modular facilities as Trust do not need to transition between modular providers and insourcing partners.

 

  1. Endoscopy is one of the most in-demand procedures in the country, but there is a significant shortage of endoscopists, and nurses trained in endoscopy. As part of our insourcing and modular solutions in Endoscopy, Remedy offers a complimentary Nurse Endoscopist training scheme for our NHS partners to nominate junior nurses in need of upskilling to complete. We are committed to supporting them develop the appropriate skills and competencies required to become qualified nurse endoscopists, creating additional capacity for our NHS partners to continue to manage the reduction of waiting times, even when Remedy has demobilised. 

 

EARLY PROGRESS MADE IN RECOVERING SERVICES

 

  1. Last year, Remedy launched a modular endoscopy unit at Carlisle’s Cumberland Infirmary. The unit has become a crucial part of local NHS plans to tackle the elective care backlog and build resilience in the regional health service. Since opening in November 2021, the £1.2 million unit has treated over 2,700 patients to help diagnose a range of conditions, including Crohn’s disease and cancer. The unit offers a full weekend service as well as early and late appointments, enabling a flexible approach to appointment times.

 

  1. Remedy has recently opened a second endoscopy unit in Blackpool, with the service expected to run until November 2023. Built in the town’s Stanley Park, this innovative unit will expand NHS capacity, with some 6,800 procedures expected to take place during this period.

 

  1. The unit builds on work already underway in Blackpool since August 2022, which has seen Remedy delivering healthcare alongside Blackpool Teaching Hospital teams in the Gastroenterology Unit at Blackpool Victoria Hospital.

 

  1. Our successes in both Carlisle and Blackpool are examples of how the independent sector can work in close partnership with the NHS to tackle the elective care backlog in original and innovative ways. Remedy is committed to supporting the Government meet its ambitious elective care targets and ready to further expand its network of modular units across the UK.

 

 

 

 

 

 

 

REFERENCES

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[1] Institute for Fiscal Studies (2022), The NHS needs to ramp up treatment volumes if waiting lists are to start falling anytime soon. https://ifs.org.uk/articles/nhs-needs-ramp-treatment-volumes-if-waiting-lists-are-start-falling-any-time-soon#note1

[2] The British Medical Association (2022), NHS backlog data analysis. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis

[3] OECD (2022), Computed tomography (CT) scanners (indicator). https://data.oecd.org/healtheqt/computed-tomography-ct-scanners.htm#indicator-chart

[4] OECD (2022), Hospital beds (indicator). https://data.oecd.org/healtheqt/hospital-beds.htm

[5] Office for National Statistics (2022), Past and projected period and cohort life tables: 2020-based, UK, 1981 to 2070. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/pastandprojecteddatafromtheperiodandcohortlifetables/2020baseduk1981to2070

[6] British Medical Association (2022), NHS diagnostics data analysis. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-diagnostics-data-analysis

[7] The King’s Fund (2022), NHS workforce: our position. https://www.kingsfund.org.uk/projects/positions/nhs-workforce

[8] British Medical Association (2022), Outsourced: the role of the independent sector in the NHS. https://www.bma.org.uk/media/5378/bma-nhs-outsourcing-report-march-2022.pdf

[9] NHS England (2022), Delivering plan for tackling the Covid-19 backlog of elective care. https://www.england.nhs.uk/coronavirus/delivering-plan-for-tackling-the-covid-19-backlog-of-elective-care/

[10] The British Medical Association (2022), NHS backlog data analysis. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis

[11] Department for Health and Social Care (2022), New diagnostic centres deliver nearly three-quarters of a million tests. https://www.gov.uk/government/news/new-diagnostic-centres-deliver-nearly-three-quarters-of-a-million-tests

[12] NHS England (2022), Delivering plan for tackling the Covid-19 backlog of elective care. https://www.england.nhs.uk/coronavirus/delivering-plan-for-tackling-the-covid-19-backlog-of-elective-care/

[13] NHS (2022), Delivery plan for tackling the Covid-19 backlog of elective care. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/02/C1466-delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care.pdf

 

November 2022