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Mobilising endoscopy services following first phase of the COVID-19 pandemic

- 20 July 2020

Following the pause of many elective procedures during COVID-19, Totally Healthcare (THC) continues forward into the new 'business as usual' as it restarts its services across the UK and Ireland. In the most recent THC blog Kaye Drew, Clinical Mobilisation Lead for THC, Totally plc's insourcing division, shares key insights on delivering healthcare following phase one of the COVID-19 pandemic after a recent endoscopy service mobilisation.

Kaye wearing PPE

As a Senior Endoscopy Nurse with over 40 years’ experience it is clear to me the impact of COVID-19 has been far reaching for healthcare professionals and patients across the world. While healthcare has been focused toward emergency response and urgent care during the pandemic, the pause of key services has caused great concern for many, especially those patients who had experienced ‘red flag’ symptoms. Restarting endoscopy insourcing services has been a key priority to providing some much-needed reassurance and treatment to those worried patients.

Following guidance from government bodies, the British Society of Gastroenterology (BSG) and the Joint Advisory Group for GI Endoscopy (JAG), we have been able to safely put our well-established clinical insourcing model into practice and restart our waiting list initiatives.

At THC we were delighted for all our staff and patients when we knew it was safe to restart services. It was clear service provision would require new and innovative ways of working and as our clinicians had been dealing with COVID-19 on the frontline during the response we were able to access the best clinical experience and expertise required to continue our high-standard of delivery in the new post-COVID-19 world.

To begin with it was critical to carry out the appropriate risk-assessments alongside our quality procedures. All elements of service delivery from the staff’s journey to the hospital, the patients’ journey and the performance of listed procedures were scrutinised against our high-quality model of practice. The provision of appropriate PPE equipment and training in latest practices was also a critical step in the mobilisation process. This planning approach provided assurance to our commissioners that patient and staff safety is paramount.

The key to our delivery success is through following our well-established high-quality clinical model of planning, attention to detail, strict adherence to clinical governance procedures and close partnership working to ensure safe solutions. Our clinical teams have always been at the forefront of healthcare, adapting to new guidelines and efficiently working in new innovative ways to get the best result for patients. We are extremely proud of how everyone has adapted and excited to continue our mission of reducing patient waiting lists across the UK and Ireland, while delivering high-quality care and an excellent patient experience.

The COVID-19 experience… how we put new guidance and restrictions into practice to develop updated, high-quality insourcing processes and a safe environment for our patients

- 24 June 2020

Dr Graham Turner, Medical Director for Totally Healthcare and Clinical Lead for Endoscopy and Gastroenterology at the Belfast Trust, describes how he has worked with hospitals to understand how new guidance can be combined into standard working practice to continue rolling out insourcing services across the UK and Ireland.


I'm sure I am not alone in wondering where the first half of 2020 has gone and how our world of healthcare has changed in what seems like the blink of an eye. Huge efforts and sacrifices by society and key workers have required us to adapt our day-to-day lives significantly. Many of the UK’s core healthcare services were paused to direct important resources towards managing the effects of the COVID-19 pandemic. In addition to the horrible toll of COVID-19 itself, this pause has created its own difficulties for patients and medical teams alike.

As the number of cases of COVID-19 falls, our focus has shifted back to rebuilding our services and in the world of endoscopy, there are new challenges to overcome. It has been a privilege, once again, to witness our teams coming together and creating ways to adapt to the new realm of social distancing and enhanced PPE. New ways of working have been and continue to be developed across the entire healthcare system.

While the postponement of services was very difficult for patients, the time was used by healthcare professionals to ensure all practices are fully in line with the latest government and NHS guidelines in COVID-19 and infection control procedures. The emerging and regularly updated guidance from the British Society of Gastroenterology and other professional bodies was also incredibly important, and we have been working hard to ensure that our patients will continue to get the best and safest treatment.

Three weeks ago, we successfully restarted our endoscopy insourcing services after an 11-week pause. Behind the scenes, we have held many discussions with the hospitals we support around COVID-19 and the safest way to restart services. One thing was very clear from the outset – the landscape has significantly changed. Specifically, we have looked at:

  • Aerosol generating procedures
  • Settling times and air exchanges
  • PPE and fit testing for FFP3 masks
  • Donning and doffing protocols

We have also met with local staff to help ensure adequate flow and social distancing for our patients. Despite these changes, we are all so pleased to be back to treating our patients. There was genuine and palpable excitement when the teams regrouped to allow many patients to have their deferred but important investigations.

Since restarting our insourcing services, we are proud to have been able to build on our experience and increase patient numbers without compromising any of the important principles we have set out. The admission, endoscopy and recovery processes are all working brilliantly, and feedback has been excellent from clients and staff alike. We have now created a safe and reassuring environment for a worried public, and we are eager to continue our ambition to reduce hospital waiting lists and get care to patients in a timely way. Thank you to everyone involved in our return.

It has been hot work in our new outfits though…

How we are supporting hospitals to move into the next phase of recovery from COVID-19

- 10 June 2020

The NHS Confederation has today warned that recovery from COVID-19 could continue for a very long time with 10 million patients potentially left waiting for important treatment. It warns that the NHS faces an uphill battle as it continues to manage thousands of very sick and recovering COVID-19 patients, maintain social distancing and restart services to treat cancer, stroke and heart care.

Marie Lee, Managing Director of Totally Healthcare, describes how the team is working in partnership with hospitals as they begin inviting patients back for elective treatment following suspension of many services during the first phase of the COVID-19 pandemic.

The insourcing healthcare division of Totally plc specialises in working with hospitals to reduce their patient waiting lists. Our expert insourcing teams utilise the hospitals infrastructure to deliver services across multiple specialties during times when the hospitals are not using some of the clinic spaces and equipment, often at evenings and weekends.

In March this year, in response to the pandemic, hospitals were forced to focus on reducing the public health threat from COVID-19 and this meant many elective treatments were put on hold. I commend the hard work of the NHS and healthcare providers across UK and Ireland in their committed fight against the pandemic.

Now as we move into a new 'business as usual', we have taken expert advice from our colleagues on the frontline and are working directly with hospitals to continue provision of multiple speciality services through our high-quality service delivery model. All our clinicians are highly experienced and have been working under new COVID-19 restrictions, so we are extremely well-placed to help reduce the ever-increasing pressure caused by long waiting lists, while managing all the new healthcare risks associated with COVID-19. We are currently performing procedures in several hospitals now and we are reaching out to expand our team to respond to the high demand from hospitals requiring help with this critical next phase of restarting elective procedures.

All Totally Healthcare's insourcing clinics maintain a safe environment where clinicians work to robust national quality standards, as well as local policies to ensure every patient is seen as quickly as possible by the most appropriate clinician in the most appropriate place.

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How does clinical insourcing work? NHS SBS experiences first-hand

- 17 January 2020

Totally Healthcare (THC) recently welcomed the NHS Shared Business Services (SBS) team to one of our services so they could experience first-hand how clinical insourcing operates.

Effective clinical insourcing services requires providers to work with commissioners by sharing and supporting them to increase their knowledge of the service solution and the benefits it offers for patient care.

Kaye Drew

Kaye Drew, Totally Healthcare’s Head of Nursing, “I was delighted that NHS SBS team made time in their busy schedule to come along to review our insourcing service, talk with patients and our clinical team”.

Marie Lee, Totally Healthcare’s Managing Director, “We are proud to be on the NHS SBS framework agreement for clinical insourcing in the UK and I am delighted the NHS SBS team found their recent experience with us so rewarding.

“We are keen to share and provide commissioners any help or information to demonstrate the cost-effectiveness and value of clinical insourcing”.

A day in the work-life - insourcing with Totally Healthcare

- 28 November 2019

Christine Roberts, Endoscopy Sister, describes working with Totally Healthcare (THC) to deliver high-quality patient care, while reducing the pressure on hospitals caused by long patient waiting lists. Based in Northern Ireland, Christine works as a Sister and enjoys insourcing work as a staff nurse for Totally Healthcare during weekday evenings and weekends, as part of THC’s waiting time initiatives.

My role as Staff Nurse in the Endoscopy setting for Totally Healthcare is a very important one. I am part of a highly skilled professional team of nurses, employed outside our main NHS jobs to provide seamless care to all patients we treat in their own hospitals. Many patients don’t even notice that it is Totally Healthcare providing the service - from the patient’s perspective if they are being seen in a timely fashion, in a hospital close to home and being treated by a high-quality team they are very happy. This is something I take real pride in because the focus is on getting care to the patient quickly, which reduces the pressure on hospitals caused by long waiting lists.

Meeting new patients is what satisfies me most about my role and being able to provide them with all the necessary and relevant information to make decisions about their own care and treatment. I enjoy the fact I can provide an excellent care journey and facilitate the best experience possible for them.

I’ve worked in Endoscopy for six and a half years, but before that I was a healthcare assistant initially, and then a nurse for 30 years.

This appealed to me as a career because I’ve always wanted to care and look after people and my sister and mother are/were both nurses – so I’ve followed in their footsteps. I also have insight into what my patients face as my father died of oesophageal cancer and my brother died at a young age of bowel cancer.

I believe if we had services to reduce pressure on hospitals, like that provided by Totally Healthcare, years ago my family may have been seen quicker and had a better chance of surviving their disease. I also enjoy helping patients who are in a similar position to my family and I think my empathy towards their challenges and what they face goes a long way.

I face many challenges in my role daily, from staffing issues to patients with complex needs, as well as hospital pressures, but despite all these pressures, my goal remains to work as hard as possible for the patient and provide the best possible outcome.

There is no such thing as an average day in my job, which is what I love about it. I’m always ready for what the day ahead brings, and I always face any challenge head on.

Every day within my role as an endoscopy nurse excites me - it’s an area I’ve been interested in for years even before I managed to secure my position as Sister. It is also such an exciting and interesting area, especially how the service is growing and will continue to do so in the future.

And finally, a little bit about me… I love fell-walking in the Lake District which keeps me fit and I enjoy kayaking in the Lakes too - when I get the chance!

Totally Healthcare selected as NHS SBS supplier

- 27 November 2019

Totally Healthcare has been selected as one of the suppliers to NHS Shared Business Services for both England and Scotland.

NHS SBS is the market leader in corporate services and provides services to around 40% of the NHS. They are experts in this field, with unrivalled knowledge and experience that helps NHS organisations overcome many of the day-to-day challenges they face.

The Totally Healthcare insourcing model supports hospitals across the UK and Ireland to reduce their waiting times, bringing high-quality care to the patient sooner, and as such is expertly placed to provide services to the NHS in England and Scotland.

Marie Lee, Managing Director of Totally Healthcare says, “I'm delighted to announce we are working with @NHS_SBS to support hospitals in reducing patient waiting times.

“We're extremely excited and looking forward to delivering high-quality patient care with our cost-effective insourcing model”.

For further information about NHS SBS, visit the website

Totally Healthcare appoints new Head of Nursing

- 27 September 2019

Totally Healthcare, part of Totally plc, has recently appointed Kaye Drew as Head of Nursing. Kaye has 36 years of nursing experience in the NHS and is dedicated to consistently ensuring a high-quality patient experience.

Kaye has specialised in Gastroenterology and Endoscopy since 1998 and became an Advanced Endoscopy Practitioner in 2006. She has successfully provided endoscopy leadership and management for endoscopy insourcing in the independent sector and is looking forward to leading the nursing division for Totally Healthcare.

Kaye says, "I am really excited by this opportunity to assist hospitals in the UK and Ireland in reducing their long patient waiting lists."

Dr Graham Turner joins Totally Healthcare

- 27 September 2019

Dr Graham Turner has been appointed as Medical Advisor for Totally Healthcare, part of Totally plc. Dr Turner qualified in 1996 and has been based at both the Royal Victoria Hospital and Belfast City Hospital since 2009, having previously been a consultant at Altnagelvin Hospital from 2006. He is Clinical Lead for Endoscopy and Gastroenterology at the Belfast Trust since 2012.

Over his career and training Graham has worked throughout Northern Ireland and completed an MD thesis in Neuroendocrine Tumours in 2004. He has also been a Clinical Fellow in Perth Australia and at UCH London. His clinical interests are Nutrition, Inflammatory Bowel Disease and Endoscopy, he is a Bowel Cancer Screening Endoscopist in Belfast.

As well as his Trust roles, Graham is currently working with the Dept of Health in Northern Ireland on Elective Day Case Centres in Endoscopy and the Regional Cancer Strategy Group for Diagnostics. He is also Medical Advisor for Crohn’s and Colitis UK in Northern Ireland. More recently he was delighted to join the team at Totally Healthcare where he is actively involved in their exciting developments in endoscopy.

Marie Lee, Managing Director of Totally Healthcare says, "I am thrilled to have Dr Turner join us our medical advisor - he has an impressive track record and I am very excited to be working together to reduce patient waiting times with our unique insourcing model."

Totally Healthcare appoints Marie Lee as Managing Director

- 17 September 2019

Marie Lee has today joined insourcing business, Totally Healthcare, as Managing Director. Marie has a wealth of experience in the healthcare sector, insourcing services in multiple specialties throughout the UK and Ireland.

In 2004, Marie co-formed Medinet, provider of outsourced and insourced medical services, treating over 620,000 patients. Marie has worked with more than 100 Hospitals, helping to reduce patient waiting times, through cost effective solutions.

She is supported by a team of experienced clinicians, including Dr Graham Turner, Medical Advisor for Totally Healthcare and Consultant Gastroenterologist at the Belfast Health and Social Care Trust.

The NHS has experienced issues over the years in reaching their 18-week targets – the time in which a patient is expected to see a specialist following a GP referral. Insourcing is an innovative way to meet these targets by using the hospital’s spare capacity in the evening and weekends to provide these services.

Marie says, “I am passionate about helping hospitals to reduce the pressures caused by long waiting lists, and importantly I am also dedicated to ensuring the highest quality care is given to patients.

“We are all users of the NHS and I am proud to work in a business which works to support getting care to patients in a timely manner.”