Working with elective care services to spread the use of quality improvement methods to sustainably improve waiting times.

The COVID-19 pandemic has significantly disrupted the delivery of elective care services leading to over 538,000 people in Scotland waiting for outpatient appointments or day case/inpatient treatment by the end of December 2021. This is a 35% increase in people waiting for outpatient appointments and 55% increase in people waiting for day case or inpatient treatment compared to the pre-pandemic December 2019 (data from Public Health Scotland).

The Access QI collaborative uses quality improvement methods to identify the root cause of waiting times issues in local service and implement solutions to change demand or increase activity, leading to sustainable reductions in waiting times. Services that have used QI to improve access to care include:

  • NHS Tayside Gynaecology service who reduced the time from referral to diagnosis in post-menopausal bleeding pathway from 137 days to 34 days 
  • NHS Border’s Psychological services who reduced the number of people waiting more than 18 weeks to access care by 49%, and
  • NHS Greater Glasgow and Clyde’s Podiatry service who reduced the time from referral to first appointment from 13 weeks to 4 weeks.


Support for elective care services

We work in partnership with NHS Education for Scotland to support elective care services improve waiting times. Our current phase is focused on supporting Ear, Nose and Throat (ENT), Gynaecology and Urology services (with a limited number of spaces for elective care services) through a SPSP-style improvement collaborative that involves:

  • a QI toolkit tailored for improving access  
  • learning sessions to enable peer to peer learning from services in other NHS boards 
  • specialty project surgeries to support the delivery of a QI project to improve waiting times  
  • one to one team coaching to share experience and help solve problems  
  • QI coaches and analysts gaining access to training modules that will develop and deepen their skills, knowledge and confidence to support participating teams, and  
  • supporting services to write and share improvement project, for example, in a case study supported with data.


Get involved

We are currently working with 15 teams across Ear, Nose and Throat (ENT), Gynaecology and Urology services with a limited number of spaces for elective care services. You can still get involved by:


Get in touch

Email us at if you have a question about the Access QI collaborative or if would like to speak to a member of the team about using quality improvement methods to sustainably improve waiting times.