MBI Health

Hitting performance targets by plugging gaps is expensive, and it only really works in the short term. Most teams know this, but when the pressure is on it’s hard to step back and take an objective look at where things are actually breaking down. As a result, some of the more fundamental questions don’t always get asked. Are referrals being properly triaged? Is triage built into clinician job plans, or squeezed in around everything else? Have pathways genuinely been reconfigured to reduce waiting times, or just stretched? Could parts of the service be delivered differently, or outside the hospital setting? None of these are new ideas, but they’re often the difference between using capacity well and constantly chasing demand. We’ve been doing a lot of work recently to make that kind of assessment easier and more structured for teams. What tends to come out of it isn’t a big transformation plan, but a much clearer view of where capacity is being lost, what can be reset quickly, and where more meaningful change is needed. In a lot of cases, the early gains are surprisingly simple once they’re visible. If you’re interested, take a look at our Operational Self-Assement Diagnostic: https://lnkd.in/eJeRR7xi

Hospitals do not have one waiting list. They have multiple representations of the same patients across RTT, diagnostics, follow-up, booking and surveillance cohorts. Those lists do not always agree. A patient can appear on more than one list 🧍🧍 Or on the wrong list 🚷 Or with no clear next action at all ❓ And that is not always visible in headline reporting. This is where operational grip becomes difficult to sustain. Our LUNA° platform provides a continuous view across the full patient population, surfacing: • Where pathways do not align across lists • Where outcomes have not been recorded or actioned • Where patients have activity but no next key action • Where data quality issues are distorting operational visibility Used by over 20% of NHS Acute Trusts, it helps operational teams move from periodic validation to continuous assurance. Find out more: https://lnkd.in/erx2vCqs

Important question from James Illman at Health Service Journal One observation from our validation experience across many trusts: the longest waits today are usually genuine. As the overall waiting list reduces, the lower waits tend to fall away first. What remains are the stickier cases. But one operational reality often sits behind this: appointments are still being booked for shorter waiters while very long waiters remain on the list. We see it regularly. Bookings happen out of date order, the “frontlog” keeps moving, and older pathways quietly stay stuck in the background. Add in genuine complexity – specialist capacity, equipment constraints, diagnostic steps – and those patients can quickly become the longest waits in the system. Which is why tackling the longest waits is so hard. It’s not just about activity. It’s about consistent operational grip on pathway management and prioritisation. We're interested to hear what others are seeing across their PTLs.

Acute Trusts have spent the past year working hard towards the 65% elective performance milestone for March 2026. Some organisations are now on the right trajectory, others still have ground to make up. But as the focus shifts to the next phase of elective recovery, one lesson is becoming clear. Elective performance rarely fails because of strategy. More often then not, it fails when the operational fundamentals drift. Referral management. Outcome recording. Booking discipline. Clock integrity. Clear ownership of next actions. These basics quietly determine whether waiting lists are visible, trusted and controlled. MBI’s Operational Self-Assessment helps organisations test the strength of those fundamentals across ten core service functions and more than 100 real-world operational scenarios. Sustainable improvement rarely starts with transformation. It starts with getting the basics right: https://lnkd.in/eJeRR7xi

Strong performance starts with strong fundamentals. MBI’s Operational Self-Assessment tests the operational basics across ten core service functions and 100+ real-world scenarios. Details via the link in the comments 👇

A patient is referred in March. They are added to the RTT PTL. In April, diagnostics are requested. In May, the diagnostic is completed but the result is not electronically actioned. In June, the outpatient team sees the patient as “awaiting results”. In July, the booking team sees them as “future follow-up”. In August, RTT reporting shows them still active, but no team has clear ownership of the next key action ⚠️ No single dramatic error has occurred, but the patient moved between teams and systems without the transitions being tightly controlled. This is how operational risk most often emerges. Hospitals do not manage one waiting list. They manage a population represented across RTT, cancer, diagnostics, follow-up, booking and surveillance cohorts. Where those representations are not reconciled, patients can be delayed or overlooked despite accurate headline reporting. Article link in the comments 👇

Hospitals do not have one waiting list. In reality, the same patients are represented in multiple ways across RTT, cancer, diagnostics, follow-ups, booking lists and surveillance cohorts. The challenge is not simply backlog, or ‘frontlog’, size. It is also what happens when the population is broken down into operational groups to deliver care, but does not fully align when reconciled. When the same population is segmented across teams and systems, then rebuilt into a single reported position, small gaps can emerge, and it is in those gaps that patients can be delayed or overlooked. Operational grip is not just about activity levels. It is about whether the whole population is visible, reconciled and progressing in the right order. Strengthening operational grip often starts with the basics, ensuring waiting lists are reconciled, aligned and trusted. https://lnkd.in/eBe8Awck

Every 28 days of delay to cancer treatment increases the risk of mortality by up to 8%.   This week’s NHS Cancer Plan rightly sets out ambitious commitments on faster diagnosis, treatment and improved outcomes. But the evidence is clear: the impact of delay is real and cumulative. Time matters, and every missed step along the pathway carries risk.   Meeting the 28-day Faster Diagnosis Standard and the 62-day referral-to-treatment standard depends on absolute confidence in cancer pathway data. Patient tracking must be accurate and up to date so that results are actioned, outcomes recorded, and patients progressed without unwarranted delay. Faster diagnostics only help if the system reliably moves patients on once those results are available.   In practice, the quickest gains in cancer performance often come from getting the basics right: robust waiting list management, complete and timely pathway updates, and clear information for clinicians at MDT so decisions can be made quickly and confidently. When the data is right, teams can focus on care, not correction, and patients can be seen and treated sooner.   *Source: BMJ analysis of 1.27m cancer pathways #NHSCancerPlan

The sprint to March is on. Extra activity, tight timelines and a real push on long waiters. For many NHS teams, this is familiar territory. What many of our teams are finding when they work alongside services at times like this is that coping mechanisms are often what’s holding the whole thing together. Spreadsheets, workarounds and manual checks become the glue that keeps services moving. Not because teams are doing things wrong, but because they’re doing what’s needed to keep patients safe under pressure. That coping is understandable. Often it’s essential. But when it becomes permanent, it can quietly introduce risk and slow progress. Seeing a coping mechanism as a signal, rather than a failure, is often the first step towards understanding where systems need strengthening. 👉 https://lnkd.in/e-HKZZcJ

The sprint to March is on and many teams are already flat out. Trusts are being asked to move quickly. More outpatient activity, more first appointments and procedures, and a real push on long waiters, all in a very compressed timeframe. We’ve been working alongside trusts on validation sprints and performance improvement projects for the past year and have already supported over 225,000 removals from the overall elective waiting list since this time last year. Our teams are already warmed up, with approaches and capacity in place from live delivery rather than theory. What often helps when the pressure ramps up: - A clear line of sight on waiting list data - Focusing effort on the pathways that genuinely move performance - Extra capacity that works with in-house teams and existing plans If it would be useful to talk as you plan the run-in to March, we’re always happy to share where we can help. Our experience has come from live delivery against exactly these kinds of asks. For more information on the NHSE sprints: https://lnkd.in/eGWWCXUu For more information on our sprint results: https://lnkd.in/eFKmt-A5