London North West University Healthcare NHS Trust recently navigated one of the more challenging moments in elective care: maintaining stable RTT reporting during and after the implementation of a new EPR.
Following the move to Oracle Cerner Millennium in July 2023, the Trust experienced the expected rise in RTT pathways for the following six months and a range of data quality issues that often follow a major system transition. For operational and performance teams, this brought added pressure during month-end and reduced confidence in the accuracy of the Patient Tracking List.
The Performance and Informatics teams recognised that restoring control of the PTL required a structured and sustained approach. Working with MBI, they delivered a comprehensive manual validation programme that corrected thousands of pathways, reduced inconsistencies and re-established a clear and reliable view of the elective backlog. Removal rates reached up to 70% during this work and the Trust was able to return its PTL to a level that supported confident reporting and daily operational decision-making.
“Stabilising the PTL after our EPR go-live took a huge amount of coordinated effort. Once we had that foundation back in place, we were able to start thinking more long-term. Bringing automation into the process has helped us retain the gains we made and maintain a level of assurance that would not be possible through manual work alone. ROVA° gives us early visibility of clock-stops and inconsistencies and because it works alongside FDP – it feeds our wider reporting and supports a much more confident month-end position.”
Tim Marshall, Head of Elective Care, LNWH
With stability restored, the Trust focused on longer-term resilience. While intensive manual validation had been essential initially, it was not a sustainable method for maintaining data quality as activity continued to grow. The team wanted an approach that reduced the likelihood of future backlogs, supported more consistent submissions and strengthened assurance across the organisation.
This preparation created the right conditions to introduce automated validation. London North West began incorporating ROVA°, MBI’s automated document-reading and validation technology, into its established validation rhythm. ROVA° uses automation to review clinical documentation, identify potential missed clock-stops and highlight inconsistencies that may affect RTT reporting. The Trust introduced automation gradually and positioned it as a complementary layer of assurance that supports the validation team rather than replacing it.
ROVA° was deployed in alignment with the Federated Data Platform, allowing it to work directly from the same underlying PTL dataset. By analysing clinical documents linked to each pathway, ROVA° highlights which FDP pathways can be safely removed from the RTT PTL and flags where further action is required. This ensures that automation reinforces existing governance processes and contributes to a more consistent and reliable view of elective activity.
The benefits of this approach are:
- Month-end reporting is more predictable and is consistently delivering a higher volume of accurate clock-stops, averaging around 1,000 each week, with about half relating to pathways above 18 weeks.
- The validation team can focus on higher-value tasks while data quality is maintained more consistently across the month.
- Automated checks now form part of the routine validation cycle and help preserve the progress made during the stabilisation period.
“What stood out at London North West was their commitment to getting the fundamentals right before moving to automation. By rebuilding stability after go-live and putting clear validation rhythms in place, they created the ideal conditions for ROVA° to add value. It has been a genuine partnership and the results reflect the effort and leadership within the Trust.”
Marta Janiszewska, Director of Data Integrity, MBI Health
London North West’s efforts have also been recognised nationally. The Trust was named one of the top 10 most improved Trusts in England as part of NHS England’s Elective Care Capital Incentive Scheme. This reflects their work to improve patient treatment, reduce waiting lists and strengthen RTT performance and is an important milestone in their improvement journey.
The Trust’s experience offers a clear and practical model for other organisations preparing for or recovering from an EPR transition or seeking a sustainable long-term approach to PTL validation. By focusing on stability first, strengthening internal processes and then introducing automation in a planned and carefully sequenced way, London North West has created a resilient validation model that supports operational teams, improves reporting confidence and enhances the reliability of elective care data across the system.
