Evidence from services

Improving referral vetting using ACRT in Gastroenterology, NHS Lanarkshire

As part of the Access QI programme, a gastroenterology team from NHS Lanarkshire wanted to reduce waiting times, decrease the time to diagnosis and treatment, and increase staff and patient satisfaction. They came together as a multidisciplinary team to implement Active Clinical Referral Triage (ACRT) and agree on a new set of referral vetting guidelines that would benefit their team and local GPs. Click here to find out what happened.


Improving patient care by assembling a Clinical Interface Group (CIG), NHS Grampian

NHS Grampian set out to simplify and improve the process of transitioning patients from primary to secondary care. They created a Clinical Interface Group (CIG) including GPs, consultants, and eHealth colleagues. The members work together to reduce waiting times, clarify pathways and tackle issues related to COVID-19. Click here to read how the CIG has achieved improvements in cardiology waiting times, Coeliac disease referral processes, and communication between patients and primary and secondary care.


Improving patient flow using a Big Room, NHS Forth Valley

NHS Forth Valley's colorectal team decided to start using 'Big Room' meetings. A Big Room gives a multidisciplinary team the time and space to discuss how to improve patient flow across their clinical pathways. Read our case study to find out how they established their Big Rooms and used them to make collaborative, data-driven decisions about pathway improvement.


Improving planned care pathways using change concepts

Using learning from across Scotland, this infographic lists a number of change ideas that enable planned care services to sustainably and affodably reduce waiting times. The change ideas span multiple steps of the patient pathway: community support, referral management, outpatients and diagnostics, and inpatients and theatre. Read more here.


Reducing the DNA rate for new appointments using driver diagrams, PDSA cycles and new referral forms in Clinical Health Psychology Service, NHS Lanarkshire

The Clinical Health Psychology Service in NHS Lanarkshire had a high Did Not Attend (DNA) rate for new appointments, resulting in long waiting times, wasted administrative time, and significant patient distress. They joined the Mental Health Access Improvement Support Team Collaborative (MHAIST) to maximise their capacity and improve access. They decided to implement telephone triage, revised appointment letters, and offer flexible appointment times and locations. Read about the impact this had here.


Remobilising services using a local capacity tool, NHS Fife

After the onset of the COVID-19 pandemic, NHS Fife needed to remobilise planned care services safely and strategically. With help from colleagues across the health board, the Transformation and Change Team Programme Manager decided to design a tool that would allow them to calculate capacity across multiple services at once. Using quality improvement tools, they mapped out each service's capacity, resources, and needs. Click here to learn how they did this.


How to collect experience data with virtual patient interviews in Dermatology and Plastics services, NHS Grampian

During the COVID-19 pandemic, a Dermatology and Plastics team used NHS Near Me to safely gather useful patient experience data remotely. They shared with us their advice and top tips for other teams looking to conduct patient interviews. Click here to learn more.


Holding a virtual team session using Kahler's 5 Drivers and the 7 step meeting process in Substance Use, NHS Forth Valley

A Substance Use service from held a virtual team development session using Microsoft Teams. They used Kahler's 5 Drivers and other tools to learn more about each other and reflect on different ways to work together as a team. Learn more about their experience here.


Increasing referrals using coaching sessions, NHS Greater Glasgow and Clyde

A team from NHS Greater Glasgow and Clyde wanted to increase the number of older people referred to primary care mental health teams (PCMHTs). They conducted coaching sessions with providers who work with older people and delivered a promotional campaign to raise awareness of PCMHTs in the community. Learn about the impact of their work here.


Increasing access to low intensity therapies by developing a self referral website, NHS Fife

In NHS Fife, a Mental Health team sought to encourage more people to self refer for low intensity psychological therapies. They hoped this would result in more available time for higher intensity therapies. They established a website which patients could use to self refer to a number of low intensity treatments. Click here to find out what happened.


Understanding your system using service user interviews in Dermatology and Plastics services, NHS Grampian

To better understand their system, NHS Grampian Dermatology and Plastics wanted to know more about the experiences of patients on the Urgent Suspected Cancer (USC) pathway. They used NHS Near Me to interview some of these patients remotely during the COVID-19 pandemic. Click here to learn how these interviews were conducted and how they helped guide the team's improvement work.


Reducing costs and waiting times using QI tools and parental input in Neurodevelopmental Assessment, NHS Dumfries and Galloway

The Neurodevelopmental Assessment team collaborated with families to design a new assessment pathway for children referred to the service. Using feedback from families with experience of the pathway, they completed a process map of the new service and made a plan to test it. Click here to learn more and find out what happened.


Streamlining a patient pathway using process mapping in Urogynaecology, NHS Grampian

A multidisciplinary Urogynaecology team came together to share their thoughts and concerns about the service. They mapped out their pathways and realised that patient waiting times varied significantly, with people living in rural areas waiting longer. They then chose several changes to test, including new treatment guidance for GPs and more direct referral routes. Read more about their work here.


Managing demand using the Wellness Model in Child and Adolescent Mental Health Services (CAMHS), NHS Ayrshire and Arran

This CAMHS team collaborated with local schools, GPs, and other community members to reduce waiting times and ensure more appropriate referrals to CAMHS. Together they have developed a guide of all local mental health services, streamlined referral processes, and encouraged schools to use CAMHS nurses as their first point of contact. Learn more about the impact of these changes here.


Improving flow using the Last 10 Patients tool in Dermatology, NHS Lothian

A Dermatology team used the 'Last 10 Patients' tool to map out the key steps in a patient pathway and take a closer look at waiting times between steps. This data helped them identify where the longest wait times were occurring and decide how to reduce them. Read this case study to learn how to complete a Last 10 Patients exercise and use it to better understand system pressures.