Insourcing capacity supports trust’s growth in demand for ECG and TTE services

Insourcing capacity supports trust’s growth in demand for ECG and TTE services


Xyla, part of Acacium Group was appointed by the University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) in July 2019 to reduce wait times within the outpatient echocardiography service at the Royal Derby Hospital site.

The challenge

Trust was facing a large backlog of patients requiring transthoracic echocardiograms (TTE) and ambulatory ECG analysis services at Royal Derby Hospital and Queens Hospital Burton, part of University Hospitals of Derby and Burton NHS Foundation Trust (UHDB). This was due to an increase in patient referrals and a shortfall in available capacity from both permanent and existing temporary staffing solutions.

The merger of the Trusts also presented a separate consideration to ensure clinical capacity for TTE and ECG services could be successfully implemented alongside both the existing infrastructure of the two Departments and the planned integration of clinical practices. 

The solution

The partnership between UHDB and Xyla, Part of Acacium Group, was initially implemented to support capacity challenges to fulfil Echocardiography lists, using Xyla’s specialist expertise to provide an insourced team of accredited physiologists and support the delivery of TTEs on a 7-day, multi-site rota.

As an independent partner with extensive experience within the echocardiography staffing market and part of Acacium Group, a leading global healthcare delivery partner, Xyla was able to access a wide pool of specialist staff from the local area who could help to increase service capacity both on weekdays and weekends.

Furthermore, with a dedicated remote clinical team, Xyla was able to offer turnaround times of 72 hours between receiving ECG readings and returning analysis reports to the Trust via the Spacelabs Remote Data Transfer utility. Delivery started with a volume of 45 TTE per week across the Royal Burton Hospital, but with increased patient demand heightened to 100 TTE per week by early 2020, prior to disruptions caused by the Covid-19 pandemic.

Following local relaxation of Covid-19 restrictions surrounding outpatient cardiology appointments and the merger of trusts, UHDB re-approached Xyla to introduce an insourced TTE service, providing capacity for 6,036 patients during a six-month period and outsourced ECG analysis service for 1,040 patients – initiated after a 6-week mobilisation process.

Matt Duffy, Operations Manager at Xyla, said: “As part of our approach with the Trust, we were able to accommodate the Trust’s requirements for weekday appointments across both sites and a split-day rota between sites for weekend appointments to ensure greater accessibility for patients. Our flexible relationship with, and efficient communications between, both the Trust our and staffing pool ensured the service could run efficiently while meeting the growing demand.”

The outcome

The main challenge to overcome was the collating of a staffing pool robust enough to ensure continuity of service and an increasing capacity requirement across the two sites at RDH and QHB.

A combination of Xyla’s reach within the staffing market and internal expertise allowed for a consistent capacity supply for echocardiography clinics at the Trust over the first 12 months of the contract, averaging:

  • 92.51% capacity (low of 72.50% in Sept 2021, high of 135% in Jan 2021) at QHB
  • 103.89% capacity (low of 81.25% in Feb 2021, high of 117.73% in March 2021) at RDH

For the remote ECG analysis service, the additional capacity supplied by Xyla to assist in clearing the existing backlog, alongside a levelling-out of the number of patient referrals coming into Trust, allowed Xyla to reduce the contracted weekly capacity by two-thirds following the initial three months of the contract. This allowed for a reduction from 40 ECG reports per week in the initial implementation of the contract down to 10-20 ECG reports per week until November 2021.

The partnership between Xyla and University Hospitals of Derby and Burton has led to the development of a successful echocardiography service within the trust, which has grown in capacity year on year, and the completion of an ambulatory ECG analysis service which has allowed the Trust to recover against a previous backlog.