Routine Elective Care Services and Direct Access to Radiology for NHS Herefordshire & Worcestershire Clinical Commissioning Group

The Commissioner requires an Independent Sector Provider to deliver the following with regards to routine elective care services:

To provide NHS patients with a clinically safe and effective routine elective outpatient, day case and in-patient service that is responsive to their needs.

• To ensure the availability and range of elective surgical providers to improve choice for patients.
• To stimulate improved efficiencies in NHS providers through collaborative working.
• To reduce the need to spot purchase from the independent sector.
• To offer services in protected elective surgical beds which are not affected by emergency demands.

The Commissioner requires the service provider to deliver the following services:-

• New Outpatient appointments
• Follow-up Outpatient appointments
• Outpatient procedures
• Day case procedures
• Inpatient procedures

The provider will perform activity within the following specialties in line with the Exclusion Criteria, as set out in the Service Specification, and in line with the host Commissioner’s Commissioning Policies:- ENT, General Surgery, Gynaecology, Gastroenterology, Orthopaedics, Ophthalmology, Urology Physiotherapy

The overall aims of this service are:

• To deliver a high-quality routine elective service that meets the needs of NHS patients, locally.
• To ensure patients receive appropriate assessment, diagnosis and treatment in a timely manner which helps reduce or prevent long term disability from their condition.
• To ensure that patients are only treated where clinically appropriate and in accordance with the patient’s host Commissioner’s Commissioning Policies.
• To achieve a maximum waiting time of 18 weeks from GP referral to commencement of treatment (noting this requirement has been impacted by the UKs Government's policy response to covid-19).
• To provide timely access to any required diagnostic services e.g. X-ray, Pathology, Magnetic resonance imaging (MRI), Ultrasound within four weeks of assessment including reports. To ensure every referral follows a pathway as agreed with the Commissioner that optimises both the patient outcome and use of resources.
• To offer choice of appointment with a directly bookable service at the point of referral.
• To demonstrate equity of access in the delivery of this service.
• To deliver a high-quality safe service compliant with all NHS regulations.
• To deliver services within a key performance indicator framework.

Furthermore, the Commissioner requires the following with regards to direct access to radiology:

Direct access to clinical radiological services is essential for modern general practice. It can shorten the time to diagnosis, which improves the quality of care. It can also help prevent unnecessary referrals to secondary care. General practitioners should have the right to request radiological examinations similar to those enjoyed by hospital consultants, bearing in mind the limitations in capacity within some departments of clinical radiology and the recommendations contained in nationally agreed guidelines on referral of patients for radiological examination.

The aim of the service is therefore to:

i. Provide a patient-centered service that is a seamless journey from referral to investigation.

ii. Provide a convenient Direct Access radiology service, with timely appointments to the local population.

iii. Provide a service that can shorten diagnosis times and hence improve the quality of care.

iv. Provide a cost-effective service which delivers value for money.

v. Demonstrate equity of access in the delivery of this service.

vi. Deliver services within a key performance indicator framework.

vii. Provide speedy reports following on from a diagnostic test.

The service will provide direct access radiology to local patients referred by Worcestershire GP commissioning consortia, covering:

i. Radiology as defined within the Korner definitions

ii. CAT

iii. Fluoroscopy

iv. Ultrasound