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Swansea Bay UHB’s collaboration with PRO-MAPP wins Technology and Digital Impact Award

We’re delighted to see our collaboration with Swansea Bay University Health Board recognised for pioneering health technology in the field of pre-operative assessments in Wales. The team took home the Technology and Digital Impact award category at MediWales Innovation Awards, rewarding the efforts of Swansea Bay UHB and PRO-MAPP’s Orthopaedic Waiting List Initiative (OWLi). 

This brief video outlines the basis of the OWLi project, and how it relates to the award nomination. Here’s more background details about our partnership, and why we’re aiming to better pathways for orthopaedic care in Wales and beyond with our digital platform.

Credit: M Horwood / MediWales

Our collaborative approach

Planned care waiting lists have grown exponentially since the covid-19 pandemic – none more so that for trauma and orthopaedics. When patients stay on waiting lists longer, their health, and especially mobility with T&O conditions, declines and the lives of their families can be impacted. The cost on primary services may also increase, where the health economics has a direct impact on those patients being fit for the planned procedure.

To remedy this heavy operational workload on healthcare staff (and therefore speedy up pathways for patients), digital platforms are better using data to fast track those most in need of surgery, and to tailor prehabilitation support for every patient. 

Monitoring patient health prior to surgery is key and undertaken by Swansea Bay UHB’s orthopaedics team, in collaboration with PRO-MAPP’s customisable digital solution. With the interactive platform, patients in waiting lists are able to self-report their health symptoms. With AI technology, the solution is able to profile then tailor pre-habilitation support services for patients, and recognises those with underlying health conditions that may require further treatment elsewhere. This ongoing process of monitoring and management assists both the patient and the Health Board/Trust, as patients can ensure that they are ready for their procedure, which has a positive mental impact and sets their expectations.

The results to date

The platform has been delivering for over two years where more than 3500 patients have been onboarded to benefit from its data-led insights. Already, those with significant conditions have been identified and supported to improve their health and halt the possibility of failed pre-operative assessments. 

Over 200 patients identified as having a significantly high body mass index (BMI) have been triaged to specialist Prehabilitation AHP weight management services. 200 smokers have been flagged and referred to shared cessation support. More than 400 patients with pre-existing health conditions requiring new blood tests were alerted to update them prior to pre assessment, where these patients would have attended and failed pre-operative assessment otherwise. The clear benefits of this intelligent approach to waiting list management means that the platform and process is being looked at for other specialities

Charting our next steps

It is critical in a digital strategy to leverage and maximise the utility of the data, and the self-reported data within OWLi is checked regularly to enhance profiling and the accuracy of the analysis. 

OWLi has collated complex comorbidity and anaesthesia data on patients, and is now delivering these results in the correct format (including RAG – Red, Amber and Green) to each team to review patients and their planned care accordingly. The countdown to pre-assessment is vital in planning RAG clinics to maximise patient flow and saving costs.

Working with Planned Care teams is also paramount to update waiting lists with relevant information, including care changes or whether a procedure was carried out privately. PRO-MAPP’s platform has the ability to adapt quickly, and deliver these beneficial services to teams that can ensure each patient is as fit and prepared for their procedure as possible. 

About MediWales

The MediWales Innovation Awards are regional and divided into Industry Awards and Health Awards, open to applications from companies operating in (or with a footprint in) Wales.

2024 saw its nineteenth edition. Learn more about all of the category winners on the MediWales website.

Assessing the long-term healthcare plans of the Get Britain Working scheme

On 26th November 2024, the UK government announced their Get Britain Working scheme, a £240 million investment to determine and fix unemployment rates and economic inactivity across the country. As part of this initiative, introduced by the Department for Work and Pensions (DWP) Secretary Liz Kendall, the government aims to up-skill healthcare efforts and provide fiscal resources and support for young people and other working-age people unemployed due to long-term illness. 

As Kendall says, “a healthy nation and a healthy economy are two sides of the same coin.” As part of its mission to get around 2 million more people into work and raise employment levels to 80%, the government looks to address waiting lists backlogs that have risen, especially since the covid-19 pandemic. 

There may be a link between long waiting lists and employment levels, considering the number of incomplete pathways NHS England experiences. But cutting down queues is just the tip of an iceberg to alleviate the healthcare system’s range of burdens, and the government will also place an emphasis on preventative care, too, as surgery cannot be the cure for every medical specialism.

A snapshot of statistics

Two of the largest contributors to health-related inactivity and economic decline are mental health and musculoskeletal (MSK) disorders, including neck and back pain, as shown in the data outlined in the scheme’s accompanying white paper:

  • Almost 3 million people are currently not working due to long-term illness – which may or may not be attributed to Covid-related cases.
  • 4.1 million employed people also suffer from conditions that can hinder their working ability, which has risen by 300,000 in the last year alone. 
  • More than 50% of people that are economically inactive due to long-term defects are aged between 50-64, also affecting the lives of families and friends as unpaid carers. 
  • The past decade has seen a fourfold increase in 16 to 34 year olds that identify their mental health as the main limiting factor to being able to work – the leading health condition for people aged up to 44 years old.
  • 40,000 people aged 50 to 64 attributed long-term illnesses to MSK conditions between 2019 and 2022.
  • A reported 1 million people are signed off from work due to MSK issues according to the Office for National Statistics, with hundreds of thousands more in backlogs for appointments in England. 
  • 33% of working age citizens (not retired) who were out of work were also on NHS waiting lists. This is compared to 19% that were employed or self-employed.

This paints a worrying picture for how a rise in serious conditions contributes to the nation’s ability to work, and in tandem places a huge deficit on a stretched NHS. This also does not take into account several other contributing factors such as orthopaedic revisions surgeries, cancer treatment, or cardiovascular diseases. 

This is why the Get Britain Working plan to get more people back into work that are currently off sick relies so heavily on NHS funding and supportive efforts, from “crack teams” to facilitate high-intensity surgical efforts to shifting to preventative methods that can save future waiting list numbers from increasing again.

The plan in action

Aims at restoring the effects of long-term sickness will soon be underway, with the government taking action fast. Funds have been introduced to cut waiting lists at the 20 NHS trusts experiencing the highest economic inactivity levels. 2025/25 also will see the Department of Health and Social Care (DHSC) receiving £22.6 billion in funds, with a pledged 40,000 elective appointments intended to be added into the NHS alongside 8,500 additional mental health staff.

These added resources look to get patients critical appointments more quickly, in a bid to return to the NHS’ standards that 92% of patients should not wait longer than 17 weeks after referral to be treated. In the case of lengthy waiting queues for MSK conditions, a programme involving multiple governmental departments looks to remedy this with an MSL Community Delivery Programme. This cooperative approach is a major contributor to successful healthcare reforms, and here involves the DHSC and teams from NHS England’s Getting It Right First Time programme – a methodology for improving standardised patient pathways through the analysis of benchmarked national data. 

A key advantage of tracking and gathering data from patient outcomes in local areas involves seeing where operational improvements can be made against more successfully cost-effective models. Local populations can benefit from shared pathway intel to design future healthcare programmes accordingly. Community services will not only feel empowered to support hospitals with high areas of waiting times, but regional focuses on employment services can help young people and inactive workers affected by long-term mental and physical health conditions back into work. And, with greater digital methods for early intervention, preventing another surge of backlogs will be possible down the line. 

It’s early days since the DWP’s plans were unveiled, but it points towards positive steps in addressing key challenges faced by the NHS, mostly huge incomplete pathways for those in dire need of treatment and the resulting economic ramifications. We’ll await further actions to see how the initiative is going in the near future.