Overview
Croydon Health Services NHS Trust provides hospital and community healthcare services to more than 385,000 people across the London Borough of Croydon. The Trust delivers a wide range of acute and specialist services at Croydon University Hospital. Adult Audiology is one of those services. TPG Insourcing was commissioned to support the adult audiology department with additional clinical capacity to manage rising referral volumes in order to reduce waiting times for hearing assessments and hearing aid fittings.
The Challenge
By early 2025, the Trust was facing a significant backlog of adult audiology referrals, with a projected DM01 waiting list of 1,406 patients by the end of March. At the start of the project, around 70% of referrals were breaching 6 week Diagnostic Waiting Time targets (DM01 report).
For this Insourcing Project, clinic space at Croydon University Hospital included two soundproof rooms / booths, available on weekends, together with 2 other clinic rooms for hearing aid fittings. From February 2025 a third room was made available Mondays to Fridays. Each hearing assessment required 45 minutes, including time for reporting. Approximately 60% of patients assessed were expected to require a follow-up appointment for hearing aid fitting. To accommodate these appointments the additional clinic rooms, mentioned above were used at weekends and during the week.
The Trust aimed to achieve a DM01 compliant position (95% seen within six weeks), together with reducing any referral to treatment pathway (RTT) breaches as well, therefore improving patient access across the service.
Our Approach
TPG Insourcing worked closely with the Trust to deliver a six-month insourcing programme using the Trust’s own premises, equipment and reporting systems. A team of 18 experienced Audiologists (minimum Band 6) was deployed to provide weekend and working week clinic cover.
Weekend clinics were supported by Band 2 reception staff, helping to manage patient flow and ensure a smooth service experience. Appointment slots were 45 minutes in length, covering both assessment and reporting, with flexibility to adjust the appointment length based on the needs of the patient and the service.
Patient booking was coordinated with the Trust, who provided weekly lists to support optimal clinic utilisation. All clinical staff were approved by the Trust prior to go-live. Hearing aids and consumables were supplied by the Trust.
Highlights
Our collaborative delivery model yielded several notable achievements during the contract:
- 6-month insourcing programme covering weekends and Monday to Friday capacity
- 18 Audiologists rostered and integrated into service delivery
- Access was given to the Trust’s system via IT and the Audiology Team Leads
- Band 2 receptionist support provided for all weekend clinics
- Service delivered using the Trust’s equipment, systems and workflows
- Strong collaborative working between TPG Insourcing and Trust teams
Outcomes
By the end of the project, the proportion of DM01 breaches had been reduced from 70% to just 5%.
The Trust successfully achieved a DM01 compliant position, with 95% of patients seen within six weeks of referral. Overall, the audiology waiting list was reduced by 65% during the six-month period.
Feedback from the Trust was highly positive, highlighting the professionalism and impact of the insourced team. The project also helped ease pressure on the substantive workforce, supporting more sustainable service delivery going forward.
Client Comments
"This insourcing project provided the help needed to reduce the waiting times. we would certainly look at using this type of project again in the future for long waits."
Head of Services, Croydon Health Services NHS Trust