Minimise patient waits

Consider whether other teams members may be better placed to receive or treat a referral, for example by:

  • pooling generic referrals
  • establishing a multi-disciplinary clinic to see certain patients - for example back pain or rheumatoid arthritis - this may appear more resource intensive, but this is offset by a reduction in appointments with the 'wrong' specialist
  • expanding the case mix seen by extended scope physiotherapy practitioners (ESPP) or nurse practitioners and encourage GP's to refer direct
  • having done so check that each discipline's timetable properly reflects the work that they need to undertake - for surgeons, the balance between clinic and theatre time is crucial
  • using partial or full booking systems to reduce DNAs and cancellations

How to do this in scenario generator

OUTCOME
CHANGE
Pooling generic referrals Link pathways together by combining the Prioritise and refer step from more than one pathway eg Knee surgery (H04) and Rheumatology outpatients (RH01)
Establish multidisciplinary clinics Add new step (= multidisciplinary clinic) to run in parallel to first outpatient attendance in one or more pathways and identify a percentage from 0-100% of referrals that will route through this clinic.  Reduce the referrals routing through first outpatient attendance to compensate
Expand the case mix seen by physiotherapy or nurse

 

Increase percentage routing through direct referral to physiotherapy or PCPI practitioners

Partial or full booking Increase GP consultation time, activate choose and book step and decrease DNA rate per provider for both outpatients and admission.  Also adjust the waiting time tolerance levels for both outpatient and admission steps to reflect people beign prepared to wait longer for an appointment with a date.  Reduce self care and private sector self routing percentages to compensate