ENQUIRE Royal Cornwall Hospital With low follow-up, high discharge and only a 2% DNA (Did not attend) rates, Medinet cleared the initial backlog within NHS tariff whilst supporting the Trust to sustain these levels. Royal Cornwall Hospitals NHS Trust is the principal provider of acute care services inthe county of Cornwall, serving a population of 450,000 people across three main hospitals. The Trust saw ever increasing waiting lists across a wide range of specialties caused by excessive demand outstripping employed resource supply in a geographically remote location. The Trust was under significant pressure to reduce its RTT waiting time targets and to provide safe effective care to increasing numbers within tightening financial budgets. Previously, Royal Cornwall Hospitals NHS Trust had tried recruiting in house and unsuccessfully exhausted all other local independent sector options before engaging with Medinet in late 2018. 3 SPECIALTIES DELIVERED 600+ PATIENTS CLEARED UNTIL THE END OF MARCH Zero SERIOUS INCIDENTS There were several significant challenges. Not only did Medinet have to meet the logistical challenge of resourcing staff to a remote location, during high levels of seasonality, but also provide enough cover and contingency to guarantee a fully managed service. The Trust were also looking to create a lasting impact, challenge the local delivery options and develop a trusted and valued partnership option to deploy as and when required. Medinet were selected for their expertise and reputation but also due to being able to evidence depth in resource backup, adapt the service to meet the unique needs and offer a multi-specialty yet flexible approach. THE SOLUTION To approach the challenge, the Medinet team acknowledged the unique setting and conducted a detailed site review to understand the delivery options. The patient list was then considered, to identify any patients who may require additional care and for monitoring and review purposes. Next, all relevant Trust protocols were identified to certify compliance standard would be upheld. Royal Cornwall Hospitals NHS Trust were involved in every step of the planning process, from collaborating on a multi-specialty strategy through consultation with their clinical teams to develop and introduce new practices on converting more GA cases to LAs where clinically appropriate. Working with the Trust, Medinet also devised a bespoke travel plan, which was routinely updated, to overcome winter flight restrictions. The model adopted later start and finish times on Saturday and earlier on Sunday specific to time of year. Starting with Dermatology, before supporting with Ophthalmology and then Urology, Medinet provided a substantive NHS consultant led fully managed service, deployed over weekends in existing theatres, for each specialty, with all clinicians working within the Trust’s space, benefitting from a supervisory governance link. The plan took a total of 1 week to devise in partnership with the service fully mobilised in just under 3 weeks, with high levels of refinement to meet the changing needs via constant and open communication channels. “Initially, we used Medinet’s service to support Dermatology with impressive results. They cleared our Dermatology outpatient backlog with excellent patient feedback. The insourcing activity also sustained a positive impact on how we operate Dermatology lists and embedded some valuable improvement in Trust practice. The next focus was to improve our RTT position in Ophthalmology. We worked very closely with Medinet in planning the operational process and to ensure listed patients would be suitable. Our more recent focus of collaboration has been Urology.As a key strategic focus to care for these patients, Medinet were able to mobilise in a matter of weeks.” THE IMPACT With low follow-up, high discharge and only a 2% DNA (Did not attend) rates, Medinet cleared the initial backlog within NHS tarif whilst supporting the Trust to sustain these levels. Across all patients seen, there were no reported incidents or complaints, which highlights Medinet’s strong commitment to patient safety and welfare. Royal Cornwall Hospitals NHS Trust immediately saw increased employee productivity and improved morale amongst their existing teams and believed the Trust were now more able to serve local demand. 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