Elective care services participating in Access QI 

Phase 3: Access QI collaborative

From August 2022, we are working with Ear, Nose and Throat (ENT), Gynaecology and Urology services with a limited number of spaces for elective care services.

Ear, Nose and Throat services:

• NHS Fife
• NHS Greater Glasgow & Clyde (Adult)
• NHS Greater Glasgow & Clyde (Paediatrics)
• NHS Highland

Gynaecology services:

• NHS Forth Valley
• NHS Grampian
• NHS Lanarkshire
• NHS Tayside

Urology services:

• NHS Grampian
• NHS Highland
• NHS Tayside

Elective care services:

• NHS Borders - Musculoskeletal Physiotherapy
• NHS Western Isles - Neurological

Phase 2: Prototyping capacity building and implementation support to use QI to improve waiting times

From May 2021 to March 2022, Access QI delivered a combination of QI training and implementation support to elective care and mental health services in eight NHS boards.

• NHS Borders: Psychological services.
• NHS Dumfries & Galloway: Orthopaedics.
• NHS Fife: General Surgery and Orthopaedics.
• NHS Forth Valley: Drugs and Alcohol services, ENT, Early Intervention in Psychosis, Endoscopy, Gastroenterology and Urology.
• NHS Grampian: Cardiac Physiology, Paediatrics MRI and Radiology.
• NHS Greater Glasgow and Clyde: Adult Gender Identity Service, Plastic Surgery and Podiatry.
• NHS Lanarkshire: Rheumatology.
• NHS Tayside: ADHD and Autism Spectrum Disorders, and CAMHS.

Unfortunately a number of services withdrew from the programme due to capacity issues related to COVID-19. For more information on the outcomes of the phase two work, please click here.

Phase 1: Accelerator sites and Flow Coaching Academy

From October 2019 to March 2021, NHS Grampian, NHS Lothian and NHS Tayside were recruited as accelerator sites to test the use of quality improvement (QI) methods to sustainably and affordably improve waiting times. In addition, NHS Dumfries & Galloway, NHS Forth Valley, NHS Grampian, NHS Lothian, NHS Orkney, NHS Shetland, NHS Tayside and the Scottish Ambulance Service joined the Flow Coaching Academy to understand more about building QI capacity and capability to improve waiting times. 

Despite the programme being suspended for six months due to COVID, the outputs of this work lead to the development of the Improving Planned Care toolkit and QI for Access Capacity Building programme. Examples of this work include:

• NHS Grampian: 
  • Using process mapping to design and implement a new and more streamlined pathway in the Urogynaecology service.
  • Introducing single vetting within the Dermatology and Plastics services to reduce both variation and waiting times. Additionally, the team Conducted virtual interviews with dermatology service users to identify challenges and opportunities to improve the urgent suspected cancer (USC) pathway.
  • Using data to prioritise the remobilisation of elective care services in a safe and sustainable manner.

• NHS Tayside:
  • The gynaecology service used process mapping to identify changes to clinics and implement a ‘one-stop’ clinic, resulting in time from referral to diagnosis reducing from 137 days to 36 days. You can find out more from the presentation at the 2021 NHS Scotland Event.
  • The colorectal service were able to implement telephone clinics and enhanced vetting to reduce waiting lists by up to 50%.
  • NHS Tayside supported the remobilisation process for elective care during COVID-19 by collaborating with HIS to create the Remobilisation toolkit.

• NHS Lothian:

  • Whilst unable to continue with Access QI due to COVID-19, the QI team successfully used the last 10 patients tool to identify improvement opportunities within dermatology’s USC pathway.  Sharing this experience at our March 2020 learning session led to services within both NHS Grampian and NHS Tayside using the tool to understand patient flow within their pathway and identify bottlenecks and areas for improvement. You can see the last 10 patient tool we developed with NHS Lothian.

Get in touch if you would like to us to put you in contact with a participating team by emailing us at his.accessqi@nhs.scot.