Sustaining a waiting list reduction through testing and adaptation

Using Realistic Medicine principles, NHS Forth Valley’s Cardiology Unit achieved a sustained >40% reduction in their pre-COVID new outpatient waiting list. Aided by a shared vision and trusting colleague relationships, the cardiology team gathered unit-level data from TrakCare and implemented multiple change ideas that helped them deliver timely and equitable care during the height of the COVID-19 pandemic. Read more about their work here.


Using multidisciplinary triage and virtual delivery to reduce waiting times

Faced with increases in referrals and staffing pressures, the pain management service from NHS Greater Glasgow and Clyde felt their service model required radical changes. With the principles of Realistic Medicine and Active Clinical Referral Triage (ACRT) in mind, they established a multidisciplinary team that met weekly to discuss and triage patients to the right clinician at the right time. They also established virtual appointments and strengthened shared decision-making between staff and patients. Read more about this team’s work here.


Reducing an outpatient waiting list using a pre-existing culture of improvement and innovation

NHS Forth Valley’s Neurology Unit came together early in the COVID-19 pandemic to redesign their service using Realistic Medicine principles. They were not affiliated with a formal improvement programme, but utilised their existing enthusiasm for improvement and innovation to effectively improve their service. A scoping exercise focused on TrakCare data indicated that Active Clinical Referral Triage (ACRT) and waiting list validation processes could help remedy long patient waits and waiting lists. This led to the development and testing of several successful change ideas. Read more about this project here.


Improving waiting times and clinic flow in a tertiary diabetes centre

Due to inefficient processes and long in-clinic waiting times, the Diabetes Centre at Singapore General Hospital decided it needed to streamline clinic flow and ensure that appointment scheduling matched up with their demand. They performed a global assessment of all clinic processes, identified their key problem areas, and tested multiples change ideas pertaining to staffing, appointment scheduling, and patient flow. Click here to learn more.


Improving access to preoperative assessment for Urology cancer patients

A Urology service at NHS Belfast Health and Social Care Trust identified that patients with cancer who were awaiting certain elective surgical procedures did not always have access to preoperative assessment appointments. When they did have access, the appointments were often not timed well and the team was concerned that these patients were not being safely prepared and informed of the risks before their procedures.

After data collection, process mapping, and bi-weekly team meetings, they decided to focus on testing and refining one change idea that they hoped would have the biggest positive impact: protected slots at pre-assessment clinics for these high-risk patients. Through multiple testing cycles, they were able to successfully refine the change idea so that eventually 95% of these patients were receiving a full pre-op assessment before their procedures. Learn more about what they did here.


Designing a Patient Initiated Follow-up Pathway to improve quality of care

To successfully design and implement a new pathway requires teams to better understand their outpatient capacity against the needs of their patients. There are a number of ways this can be done. Read about NHS Lanarkshire’s experience in our learning summary.


Telephone clinics and enhanced vetting reduce waiting lists by up to 50%

As part of referral management, colorectal consultants in NHS Tayside used enhanced vetting and telephone consultancy to significantly reduce waiting times for new and returning patients. Find out more from our learning summary.


Using pre-clinic telephone consultations to reduce clinic waiting times

A postmenopausal bleeding clinic in NHS Ayrshire and Arran began contacting patients by phone prior to face-to-face appointments. This allowed them to check on patient wellbeing, ease any fears about upcoming appointments, and prioritise urgent cases. As a result, waiting times decreased and the clinic became more efficient. Find out how from this learning summary.


Smartphone app empowers patients with long-term conditions

New technology can help teams find creative, high-impact ways to connect with patients and reduce the need for in-person appointments while maintaining a high standard of care. A joint initiative between Chelsea and Westminster Hospital NHS Foundation Trust and ViiV Healthcare has designed a new app for patients. Learn more from our learning summary.