Project Name: GHNHSFT One Stop hub and spoke service redesign Joint working

Project Summary:

At present newly diagnosed and existing patients with wAMD have to access ophthalmology imaging services (OCT) at GHNHSFT (Gloucestershire Royal Hospital and Cheltenham General Hospital acute sites).

Due to capacity constraints and the implementation of COVID-19 infection control measures throughput and capacity within for Medical Retina and other sub-specialty clinics has reduced. The increase in aging population has also lead to a year on year increase in patient referrals.

This has led to significant delays in initial review and follow up appointments, resulting additional anxiety for patients and carers and increased pressure on a service which is already at capacity.

The Trust serves the population across Gloucestershire and has identified a possible opportunity to bring care closer to home by implementation of a hub and spoke model. Stroud has been identified as the Spoke site

The aims of the project are to therefore:

  • Align ophthalmology services to the strategic priorities set out in the NHS LTP and GIRFT agenda by creating a ‘one stop service’ bringing care closer to home and thus improve patient access to ophthalmology services across Gloucestershire hospitals ensuring patients are seen in the most appropriate care setting.
  • Improve the management of wAMD through enhanced system architecture and purchase of additional equipment, , ensuring new patients are seen and medically optimised earlier thus improving outcomes for patients with wAMD and within the other sub-specialities in the short, medium and longer-term.
  • Increase service capacity and efficiency by improved utilisation of space.
  • Increase service capacity and efficiency by improved use of resource by empowering the wider workforce to better manage patient flow.
  • Facilitate the use of novel treatments and NICE guideline directed therapy for patients with wAMD.
  • To support the Trust in overcoming the challenges associated with implementing their post Covid-19 recovery plans.

Covid-19 has magnified Trust pressures around ophthalmology services causing further delay to treatment for patients. Therefore, working in partnership with Trust to create a community ‘one stop’ service which improves service delivery for patients leaving within this area and will result in improved quality of care for patients and address the unmet need for this locality. This project will release space in the acute environments for patients living within their postcodes thus improving general access to care for a wider cohort of patients.

Planned Milestones:

  • Kick-off meeting held with key stakeholders to discuss / agree project plan and collection of baseline patient satisfaction scores.
  • Initiation of building works and pathway readiness including imaging installation.
  • Initiation of clinical activity at spoke sites
  • Collection and analysis of 3 month data
  • Collection and analysis of 6 month data
  • Collection and analysis of 9 month
  • Write up of methodology and case study.
  • Submission of business case

 Expected Benefits:

Anticipated Benefit to Patients

  • Reduction in waiting times for patients to receive treatment of wAMD therefore accelerating time to treatment and reducing risk of sight loss.
  • Reduction in waiting time for existing patients to access ophthalmology service’s and receive specialist input both within community and acute sites.
  • Reduction in the number of outpatient attendances at the main site and an increase in the number of patients seen closer to home thus reducing the burden on patients and carers.
  • Rapid, efficient access to wAMD services across the clinical pathway.
  • Improvement in patient reported outcomes and satisfaction scores through quality audit from baseline.
  • Improved access to all therapies for the treatment of wAMD.
  • Improved access all patients requiring intravitreal injection treatment
  • Improved access to appointment within virtual environment

Anticipated Benefit to the NHS 

  • Increase in total capacity to deliver MR service across all indications delivered through a one stop, one site community service.
  • Increase in total capacity to deliver other sub-specialty services within the acute environment.
  • Increase the number of patients able to access ophthalmology service’s and receive specialist input from baseline.
  • Rapid, efficient access to wAMD services across the clinical pathway.
  • Improvement in patient reported outcomes and satisfaction scores through quality audit from baseline.
  • Improved access to all therapies for the treatment of wAMD.

Anticipated Benefit to Novartis

  • Improved access to innovative novel therapies for the treatment of wAMD.
  • Improvement in patient reported outcomes and satisfaction scores through quality audit from baseline.
  • Enhanced reputation as partner of choice in working in collaboration with the NHS.

Start Date and Duration: April 2022 – October 2023 (18 months)

UK | 429265 | April 2022