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Respiratory team aim to meet outpatient 18-week wait

02 March 2007

Clinicians and managers are working together to reduce waiting times for outpatients suffering from respiratory conditions including lung cancer, sleep problems, asthma, chronic obstructive pulmonary disorder (COPD) and TB.

Clinicians and managers are working together to reduce waiting times for outpatients suffering from respiratory conditions including lung cancer, sleep problems, asthma, chronic obstructive pulmonary disorder (COPD) and TB.

A team led by Dr Dilys Lai, Lead Consultant for respiratory medicine, and Narinder Liddar, Acting General Manager for the medicine directorate, has mapped patient pathways, identified delays, and taken action to minimise delays.

Their work is part of a Trustwide approach to meeting a national target that by 2008 no NHS patient in England should wait longer than 18 weeks for treatment, from GP referral to the start of their hospital treatment.

Dr Lai said: “If we are going to meet the 18-week target in our specialty and across the Trust, it is crucial that clinical staff come on board to identify solutions that will reduce waiting times and improve patient care.

“Patient pathways in respiratory medicine involve doctors, nurses, our lung function technician, imaging staff, support staff working in outpatient clinics, phlebotomists, medical secretaries and many other staff.

“If just one of those groups of staff isn’t working well or isn’t involved in improving patient care, the whole patient pathway will fall apart.”

Narinder agreed: “We need joint ownership of both problems and solutions from clinicians and managers.”

So what has the mapping of respiratory patients’ pathways revealed?

Dr Lai said: “It is the first time we have had this level of detail about how care is delivered currently. It’s absolutely vital because we cannot improve our service if we don’t know what we are doing well, what we could improve and what demand there is for the service.

“We have identified that a one-stop clinic approach is the way forward because patients like the fact that they can receive all the different tests and investigations they need on one day, and this will reduce waiting times.

“Now we need to look in detail at how one-stop clinics would work in practice and what the implications are in terms of staffing and financial resources.”

Narinder added: “Some solutions require capital investment and have revenue implications short and long term, and so they require approval from the Board of Directors, but there are some delays that we can tackle immediately through relatively simple steps.

“For example, Dawn Evans (Lung Function Co-ordinator) is a crucial member of the respiratory team because she performs all breathing assessments. A lot of her time is currently spent on admin tasks and so we are providing extra administrative support to free up more of her time for patients.”

Mapping patient pathways has also uncovered that 15% of respiratory outpatients do not attend their appointments.

Dr Lai said: “We now need to dig deeper to find out who is not attending and why not before we can then decide how to tackle the problem by, for example, phoning or texting patients the day before their appointment as a reminder.

“The answers to delays and bottlenecks are not always complicated or expensive – sometimes it’s the simplest things that don’t cost us anything that make the biggest difference to our patients’ care.”

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