The Operating Theatre Journal - Flipbook - Page 8
Region-wide AI deal to help tackle waiting lists
across nine NHS trusts
The Cheshire and Merseyside Integrated Care System has signed a new agreement with its technology provider C2-Ai, to
signi昀椀cantly expand a high-impact waiting list initiative across all its acute hospitals.
The ICS, one of the largest in England, will now start to scale successes
already achieved by several trusts in the region, where pioneering NHS
teams have deployed an AI-backed decision support model to help 昀椀nd,
prioritise and support some of the highest-risk patients on waiting lists.
Improved outcomes, fewer A&E admissions and shorter hospital stays,
are just some of achievements recorded at early adopter hospitals. This
follows the introduction of technology from UK company C2-Ai, which
昀氀ags previously hidden risks for patients and suggests speci昀椀c actions
for clinicians according to parameters they set.
Surgeons and operational teams have embraced the technology where
it has already been deployed, using the system to save many hours
in prioritising lists, and to help to determine when, where and how
to treat patients to deliver the best outcome. Health and care teams
have also been able to provide targeted support to patients on waiting
lists who are identi昀椀ed at risk of deterioration, in a pre-habilitation
programme called ‘waiting well’, leading to signi昀椀cantly improved
outcomes following surgery.
Professor Rowan Pritchard-Jones, medical director for NHS Cheshire
and Merseyside, said: “This is an entirely different way of working,
helping us to identify and prevent risks becoming reality for many
patients. Our use of AI as a tool to help prevent harm, has the potential
to enable some of the biggest changes in 75 years around how waiting
lists are safely managed in the NHS.
“Delivering successful healthcare at a time when resources are in high
demand, means 昀椀nding those in greatest need, and creating genuine
impact for them. That’s what some of our pioneering teams have
already been doing with the help of technology, and we will be working
with many others to ensure they have an opportunity to embrace tools
now available.”
The innovative AI model was 昀椀rst introduced at a number of the
region’s hospitals in 2020. Busy surgeons were able to use technology
to quickly identify and gain a detailed understanding of their highest
urgency patients and use clinical decision support to act and more
safely address backlogs during the summer months.
An NHS England assessment of the 昀椀rst 125,000 patients to be managed
through the system, found a two-thirds reduction in the need for
ICU for the highest risk patients, 125 bed-days saved for every 1,000
patients on the waiting list, an 8% reduction in emergency admissions,
and reductions in avoidable harm.
The system works by harnessing information relating to patients across
multiple care settings and calculates their individual clinical risks as
information changes. It then suggests priority scoring to surgical teams,
provides insight on where best to treat them in the region, and can
indicate required prehabilitation support for patients as they wait to
prevent them becoming more unwell.
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Dr Mark Ratnarajah, UK managing director for C2-Ai, said: “This means
that patients on waiting lists can be managed based on a detailed and
near real-time understanding of their changing clinical needs, impacts
of social determinants of health and risks from decompensation either
from their underling condition and or their multimorbidity, rather than
basing decisions only on time on waiting list and type of procedure.
“As we work closely with multidisciplinary teams across the region to
understand how we can meet their needs and gradually expand this
important programme, we will create new opportunities to release
their time to focus on clinically important work. The programme is
creating valuable new intelligence for busy healthcare professionals,
who have been highly con昀椀dent in the technology, but who also remain
in full control of decisions. This is a powerful example of using AI for
good.”
The clinically-led AI model, pioneered in Cheshire and Merseyside,
has been shown in peer-reviewed studies to be highly accurate in
identifying speci昀椀c risks of harm and mortality for patients on waiting
lists. It has been the subject of Royal College of Surgeons funded health
economic analysis, has been recognised in multiple awards, and was
looked to as an example of best practice internationally at the World
Congress of Prehabilitation in July 2023.
The model and underpinning technology, which already assesses risks
on 250,000 patients a week in the region, will be made available to
teams at all nine acute trusts across Cheshire and Merseyside. This
includes:
• Countess of Chester Hospital NHS Foundation Trust
• East Cheshire NHS Trust
• Mid Cheshire Hospitals NHS Foundation Trust
• Liverpool Heart and Chest Hospital NHS Foundation Trust
• Liverpool University Hospitals NHS Foundation Trust
• Liverpool Women’s Hospital NHS Foundation Trust
• Mersey and West Lancashire Teaching Hospitals NHS Trust
• Warrington and Halton Teaching Hospitals NHS Foundation Trust
• Wirral University Teaching Hospital NHS Foundation Trust.
Dozens of NHS trusts across the country have now started to replicate
work seen in Cheshire and Merseyside. With close national interest
shown in the region’s waiting list initiatives, and regional support from
organisations including the Innovation Agency and wider Academic
Health Science Networks, it is hoped achievements could soon be
scaled even further across the NHS.
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