Challenge 

Elective care backlogs placed significant pressure on Swansea Bay University Health Board, particularly within orthopaedics. Patients waiting for hip and knee surgery were often deteriorating while on the list, with no systematic way to monitor changing health needs or intervene early. 

Many patients reached pre‑operative assessment with unmanaged modifiable risk factors — such as uncontrolled diabetes, obesity, smoking, or anaemia — resulting in late cancellations, avoidable delays, and wasted clinical and theatre capacity. The Health Board needed a digital solution to monitor patients dynamically, provide targeted support, and improve readiness for surgery. 

Solution 

Swansea Bay University Health Board co‑developed NEC Health Engage Monitor, a digital platform enabling patients to self‑report their health and wellbeing while they wait for surgery. 

The platform integrates this patient‑reported information with clinical records to create a real‑time, dynamic view of each patient’s health status. Intelligent technology identifies patients with elevated health needs, prompting: 

• Targeted clinical review 

• Early optimisation of comorbidities 

• Personalised lifestyle and wellbeing support 

• Direct referrals to prehabilitation services such as weight management, physiotherapy, smoking cessation, and education 

Risk stratification enables low‑risk patients to move through streamlined, high‑volume pathways, helping the Health Board maximise its elective care capacity. 

Equity was embedded throughout the design. Assisted onboarding, telephone support, and printed guides ensured accessibility for patients with lower digital confidence. The platform was developed through co‑production with patients, carers, and clinicians, and refined continuously based on user feedback. 

Results 

Between January 2023 and January 2024, NEC Health Engage Monitor delivered significant improvements across waiting list management and patient readiness: 

• 3,564 patients supported on the platform 

• 71% patient compliance rate 

• 500+ failed pre‑operative appointments avoided 

• 1,176 patients referred to prehabilitation services 

• 2,183 patients received osteoarthritis exercise and education support 

• 475 smokers offered smoking cessation help 

• 192 haemoglobin, 276 HbA1c, 218 kidney function, and 20 thyroid function tests triggered, ensuring earlier optimisation 

• 404 patients (8%) removed from the waiting list as no longer suitable for surgery — improving accuracy and freeing clinical capacity 

These outcomes reduced late cancellations, ensured earlier management of comorbidities, and improved the overall readiness of patients progressing to pre‑operative assessment. 

The NEC Health Engage Monitor platform was also recognised nationally, winning the Digital & Technology Innovation Award at the Advancing Healthcare Awards Cymru 2025 for its impact on reducing orthopaedic waiting lists and improving patient optimisation.

For more information about NEC Health Engage Monitor and how it supports digital waiting list management and prehabilitation, please contact our team or visit necsws.com/health.