Royal Devon & Exeter NHS Foundation Trust Case Study

Improving patient accessibility for echocardiography services at Royal Deon & Exeter NHS Foundation Trust

The Client

The Royal Devon & Exeter NHS Foundation Trust provides high-quality integrated health and care services in Exeter and across Eastern and Mid-Devon to roughly 450,000 people.

One of the first NHS Foundation Trusts nationally in 2004, and with a history dating back over 250 years, they are directly accountable to and work with local people and communities. The RD&E has earned a national and international reputation for the provision of high-quality healthcare, innovation, research and education.

The Challenge

Due to an increase in demand for services, the Royal Devon and Exeter Hospital required extra clinical capacity to increase patient access to transthoracic echocardiography services. Another contributing factor to the challenge was the historical nationwide shortage of suitably qualified Cardiac Physiologists to support the vacancies that the Trust required to be filled.

The Solution

Xyla was approached by the Trust in mid-2019 with a request for additional clinical capacity to increase the department’s ability to provide transthoracic echocardiography services for an increasing number of monthly patient referrals. Xyla was initially contracted to supply echocardiography services to a volume of 1,210 TTE scans during the first 22-week period, with a 26-week extension period to a minimum capacity of 600 TTE scans.

Due to a large increase in patient referrals, and the successful supply of TTE capacity in the initial term of the contract, the Trust requested a new agreement commencing early May 2020 for the capacity provided by Xyla to increase to 160 TTE scans per week for an initial 35-week period, with a further capacity period to be agreed beyond this. The increase in capacity here was represented by the provision of three full-time Physiologists, compared to one full-time Physiologist in our first contract with the Trust. Through this period, Xyla was able to provide the capacity to support:

• 4,914 patients seen over an eight-month period
• 474 echocardiography clinics filled
• 88% patient capacity achieved

The capacity provided was agreed to continue to the same levels for the remainder of the contract, through April 2021, where Xyla was able to provide a further:

• 2,390 patients seen over a four-month period
• 218 echocardiography clinics filled
• 88% patient capacity achieved

Through April 2021, and due to the successful implementation of a long-term, high-volume echocardiography solution, Xyla was invited to re-contract with the Trust to retain our partnership for a further 12-month period. This new requirement was agreed upon at a level of 144 TTE scans per week for an initial 26-week period until the end of October 2021 to a volume of 3744 patients, with a further 26-week capacity to be agreed upon during our Service Review meetings. Through the course of the current agreement, Xyla has provided the following:

• 3,416 patients seen over a 6-month period
• 311 echocardiography clinics filled
• 91% patient capacity achieved

Looking Forwards

Xyla is very proud of our achievements throughout our partnership with the Royal Devon and Exeter NHS Foundation Trust and the work that has been undertaken by our dedicated team of staff. Through an extremely challenging two-year period we have been able to ensure continuous service to the Trust and, further, have been able to increase the overall efficiency with regard to the percentage of clinics filled per week by our on-site team.

During the course of our partnership with the Trust – now totalling in excess of two years, Xyla has been able to ensure coverage for a total of:

• 10,720 patients seen
• 1,003 echocardiography clinics filled
• 9,420 hours of clinical work
• 91% patient capacity achieved

Xyla understands that we provide a real benefit to the Trust through the work we continue to do and look forward to our continuing partnership through the remainder of our current agreement and future work together.