Priority 1 - Modernising Patient Pathways
Drive transformational and sustainable change to improve planned care patient access and outcomes across NHS Scotland.
Responsible Team: Modernising Patient Pathways (MPP) Programme
The deliverables and outcomes for this strategic priority are described below.
Utilise SDGs to develop and implement national clinical pathways and high-impact process changes across NHS Scotland
Over the year, the MPP team continued to develop the Speciality Delivery Groups (SDGs). The SDGs are designed to drive consensus and clinical participation, and serve as a vehicle to develop high quality services across NHS Scotland, reduce unwanted variation, promote “best in class" services and sustainably improve waiting times for non-urgent care.
All SDGs developed and agreed their work plans. A key element of the work plans included the development and approval of national clinical pathways for key conditions and other supporting resources.
A total of 43 national clinical pathways and supporting resources have been published, and made available for NHS Boards for local implementation.
Implementation of high-impact and productive approaches
The SDGs worked with NHS Boards to promote and implement high impact changes, including Active Clinical Referral Triage (ACRT) and Discharge Patient Initiated Review (PIR).
Over the year, the use of ACRT has allowed over 138,000 patients have been returned to primary care in 10 specialties with advice or added to an opt-in pathway. This is an increase of 89% compared to last year. A conservative estimate of the cost of seeing those patients in outpatients is in excess of £24M. This equates to 2,249,000 miles of patient travel avoided.
In addition, over 71,000 patients have been added to discharge PIR pathways in 10 specialties, which is an increase of 65% compared to last year. A conservative estimate of the cost of the cost of seeing those patients in outpatients is almost £11M. This equates to 1,278,000 miles of patient travel avoided.
Deployment of Measurement plans through Heatmaps
Ongoing Heatmap meetings with over 100 Heatmap submissions covering 10 specialties, were successfully held with Boards throughout the year. This work allowed CfSD to successfully monitor improvement throughout the year, including the implementation of ACRT, PIR and other high-impact changes.
Board engagement and improvement support
The MPP team participated in Board Engagement meetings that were regularly held with all Boards throughout the year. This provided an opportunity to discuss CfSD’s national improvement work with CfSD Board Champions and other senior managers, and to identify key local priorities and areas for improvement.
Develop infrastructure to support measurement, reporting, and publication
MPP have developed an internal process to support the active dissemination of knowledge through the publication of academic papers. This is designed to share best practice and promote the work of CfSD.
Over the last year, the MPP team have published 9 papers. In addition, a further 3 papers are under review to be published in the near future. See Appendix 1 for a list of these papers.