The Cheshire and Merseyside Acute and Specialist Trusts Collaborative (CMAST) elective recovery and transformation programme was established from a necessity to reduce waiting times for treatment following the immediate impact of the Covid-19 pandemic. The providers agreed that it was imperative for the collaborative to share resources, provide support, and facilitate mutual aid to ensure urgent patients still received treatment and as much elective care continued as possible.
Action taken
A mutual aid hub/patient tracking list (PTL) team was established to track and monitor requests for mutual aid and the waiting list position within each organisation to minimise variation. This work is underpinned by weekly monitoring of waiting times across the system, fostering a shared responsibility for reducing variation in wait times between providers.
Capacity was optimised through a theatre utilisation programme. This uses risk stratification to help prioritise patients for different clinical risk factors to ensure patients were seen in order of clinical need. Theatre and outpatient dashboards are used to monitor utilisation rates and cases per list, day case rates, patient initiated follow up and referral optimisation.
A prehabilitation programme identifies patients at high risk of chest infection and contacts them to offer health coaching and respiratory physiotherapy at home, and to get diet coaching and pre-surgery support.
Underpinning this work are memorandum of understandings for staff and services so they can move more easily within the system.
Outcomes and impact
CMAST has realised significant outcomes as a result of this programme, including consistently achieving their Elective Recovery Fund target of 104.9%, and in 2022/23 they secured over £40m of additional income.
They have also increased the number of people receiving operations within Cheshire and Merseyside through improved theatre utilisation and efficiency and their further faster programme has helped avoid over 170,000 appointments in the first half of 2024/25.
The collaborative has sustained zero capacity breaches for 104 week waits since March 2022, and reduced the 78-week waits down to a small number of capacity breaches. They are also down to just over 1,000 65-week breaches and making progress on their 52-week cohort.
Cheshire and Merseyside Acute and Specialist Trusts Collaborative is a large provider collaborative of 13 trusts (full details here). You can read more about both their diagnostics and elective recovery programmes in our case study here.