"Edge helped us to put the plan back into planned care."
Director of Strategy & Transformation at South Tees Hospital.
Overview

Space Finder is an intelligent theatre scheduling software solution that supports booking staff in acute hospitals to effectively schedule elective operations into available theatre space.

With more patients waiting for surgery and trusts facing hours of unused theatre space every day, utilising time effectively is a key strategic goal for NHS Improvement and NHS England. Using existing resources, a potential 300k/year additional elective surgery is possible given a reduction in theatre time lost to late starts, early finishes and delays between operations.

Computer assisted booking through Space Finder makes this complex job easier and helps hospitals utilise expensive resources more efficiently. It has been independently evaluated by Kent Surrey Sussex (KSS) AHSN and demonstrates increased theatre utilisation when used by booking staff alongside their regular booking processes.

Space Finder can assist hospitals to complete an additional 13% in surgical procedures per operating list with current resources. Using machine learning it accurately estimates operating length, and then schedules operations optimally for the available theatre space while also considering factors, such as equipment availability and staff availability to help avoid any last-minute cancellations. It has been highlighted by the CQC as “Outstanding practice” and is now being scaled across the NHS.

South Tees NHS FT, the first adopter, has already saved £3m since 2017 from fitting more elective procedures into existing theatre space and shut down expensive out of hours working.

*https://improvement.nhs.uk/documents/3711/Theatre_productivity_report__Final.pdf

Challenge / problem identified

The NHS needs to rapidly adapt and change if it is to continue to care effectively and efficiently for a growing population of older people with complex conditions generating combined health and social care needs. NHS England set a clear strategic direction to achieve this in the Long Term Plan.

This demographic shift and a lack of relative resourcing has resulted in an increasing numbers of patients waiting for elective surgical procedures and longer waiting times. According to the winter pressure 2018/19 report from the BMA*:

  • Patients waiting for treatment rose over 4.3 million in February 2019, a 300,000 increase from February 2018.
  • The median wait for treatment in February 2019 was 6.8 weeks, up from 2018.
  • In January and February 2019 over 530,000 people had waited over 18 weeks for treatment, a 20% increase from 2018.

Acute hospitals often struggle to schedule waiting patients efficiently; NHS Improvement has found that UK hospitals have an average of two hours of unused theatre space per day per theatre** at least in part due to complex booking processes that can make it difficult to effectively take into account all theatre, surgeon and patient specific factors.

Booking staff need increasingly sophisticated tools to manage their growing workload. Space Finder reduces workload and allows booking staff to predict how long operations take by taking into account patient factors, hospital factors and surgeon factors (i.e. comorbidities of patients, specialities of surgeons, equipment available in hospitals) effectively and efficiently supports scheduling of patients into available space.

*NHS Pressures – Winter 2018/19, BMA, available here: https://archive.bma.org.uk/collective-voice/policy-and-research/nhs-structure-and-delivery/monitoring-quality-in-the-nhs/pressure-points-in-the-nhs/winter-pressures

**https://improvement.nhs.uk/documents/3711/Theatre_productivity_report__Final.pdf

 

Actions taken

Space Finder has been developed by Edge Health alongside frontline staff at NHS trusts in South Tees in 2017 and further rolled out to Ashford and St Peter’s Hospitals NHS FT in 2018 and Sandwell and Birmingham (go-live in early 2020). It has been supported by KSS AHSN as well as the DigitalHealth.London accelerator.

By working closely with booking staff and theatre managers during the development process, the SpaceFinder technology was integrated into the current booking processes smoothly and has helped improve the usability of the new system.

KSS AHSN has undertaken an independent evaluation of Space Finder at Ashford and St Peter’s Hospitals NHS FT. The report highlights positive results around increases in theatre utilisation and the number of surgical procedures completed per operating list.

The solution is now scaling across NHS trusts with the goal of reaching at least half of the trusts in England in the next five years helping millions of patients receive their elective surgery faster.

Impacts / outcomes

Space Finder has been deployed at several trusts across the NHS and evaluated by KSS AHSN. Findings below:

  • Space Finder has helped South Tees NHS FT to increase their theatre throughput by 50 extra cases per week, an increase that has been sustained since rolling out the solution in 2017. This allowed them to turn off expensive out of hours and weekend working to save c. £3 million per year.
  • In July 2019, KSS AHSN undertook an evaluation at Ashford and St Peter’s Hospitals NHS FT on the impact of Space Finder which was implemented earlier in the year (https://www.edgehealth.co.uk/post/spacefinder-evaluation). It found that Space Finder, through highlighting available space and supporting optimal scheduling of surgery, delivered:
    • 3% increase in surgical procedures per list
    • 1% reduction in theatre use outside of core hours
    • Up to 7.1% higher theatre utilisation
    • £330,000 worth of additional surgery within the first year.

Space Finder is also currently being rolled out at Sandwell and Birmingham NHS Trust.

Space Finder has been highlighted by the CQC as “Outstanding practice”. (https://www.cqc.org.uk/sites/default/files/20190628%20S%20Tees%20Hospitals%20NHS%20FT%20UoR%20FINAL%20FOR%20PUBLICATION.pdf)

Plans for the future

We are aiming to spread Space Finder across the NHS and continuously work on developing the following areas:

  • Ever more efficient lists and accurate predictions
  • Algorithms based on privacy preserving or enhancing technologies (PETs).

Working with KSS AHSN and the DigitalHealth.London Accelerator to further the spread and adoption of Space Finder to ensure patients have the surgery they need when they need it.

Which national clinical or policy priorities does this example address?

Cutting long term waits, increasing amount of planned surgery and reduction of waiting list are all part of the NHS Long Term Plan. Space Finder directly supports this vision.

Where did the innovation originate from?
  • The innovation originated from collaborating with the trust mentioned in this case study.
Which AHSN priorities does this example cover?

System enabler projects:

  • Data integration / interoperability
  • Digital health (including road maps and enabled care services).

Workforce development (including capacity and capability building and patient and public leadership).

Start and end dates:

The work started in 2017 and is ongoing.

Project contact for further information

George Batchelor – george@edgehealth.co.uk

Christian Moroy – christian@edgehealth.co.uk

Media contact for further information

Rick Fell, Head of Communications, KSS AHSN

E: rickfell@nhs.net

M: 07827 369797.