Change Management

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NHS Tayside Community Physiotherapy Service Case Study  waiting times reduced from 14 plus weeks to a “  waiting maximum of 2 weeks ”

Vanguard Scotland

 

Vanguard Case Study: NHS Tayside – Community Physiotherapy Service Case Study

The Issues:   The seasonally adjusted waiting time to get a Community Physiotherapy appointment in the NHS Tayside region was 14 weeks and increasing.



  Year on year, demand for the service was increasing.



  The Community Physiotherapy Physiother apy Department was required to make a 3% financial saving.



  15% of of the department’s resources were required to undertake undertake new new work. work.



The main challenges for the system were:   Highs level of patients who did not show for appointments (DNA)



  Referral information not coming in “clean” from GPs



  A lack of resources to deal with demand and high levels of “failure” demand as patients phoned in to chase referrals



The soluti ons th ey ha had d alrea already dy tri ed unsuccessfully:  A number of traditional traditional solutions solutions had already been been implemented to tackle these problems. NHS Tayside’s efforts to identify the reasons for patient DNAs had reduced them to  just over 10%, but the solutions consumed consumed resources and added added lots of time time to issuing the appointments. appointments.  A number of guidance guidanceinnotes and ttraining raining sessions sessions had been offered offered to GPs but there was no improvement referral information. Triage had been introduced to speed up urgent patients, but due to insufficient information triage was often performed twice to get it right. This used up yet more m ore of the thinly stretched physiotherapy resource, slowed the appointment process by up to 3 working days. 20% of patients subsequently classified as urgent were not and 15% patients classified non urgent were urgent. The “solutions” had consumed more resources, introduced errors and become a part of the problem. Clearly a different approach was required to achieve performance improvement.

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Vanguard Case Study: NHS Tayside – Community Physiotherapy Service Case Study

 A Syst Sy st ems Sol ut utii on :  A team comprising comprisin of staffClinical from the Community Communityteam Physiotherapy Physiothe rapy with withreview the of assistance of the g Tayside Governance carried outService a systems the assessment process using Vanguard’s Vanguard’s Systems Thinking Methodology for performance improvement. improvement. Following this assessment an experiment was carried out using 14% of the overall physiotherapy physiotherap y resources (these resources dealt with 26.9% of overall demand). Physiotherapists spent time with GPs in the Physiotherapists t he experimental practices to understand the problems they had with referrals. New methods for referral were trialled with astonishing results. Work was reduced through cutting out “wasteful” practices and re-designing re-designin g process flows.

The Results: Results:   Demand in the experimental practices was successfully successfu lly reduced by 45%



  Patients not not showing showing up (DNAs) (DNAs) for first appointments appointments were almost eliminated



  Patient waiting times reduced from 14 plus weeks weeks to a maximum of 2 weeks



  Finally, 3 Physiotherapists Physiotherapists (10% of resources) resources) were released to take on work work which had been sitting on a development list awaiting funding.



Patients, GPs and Physiotherapists all loved the new system and are helping the Clinical Governance Team and the Community Physiotherapy Team implement the new system in the remaining practices.

“ As  As a result of using Vanguard’s Vanguard’s Methods, our client waiting time to see a physiotherapist physiotherapi st went from 14 weeks weeks to 4 days. If you want a dramatic dramatic improvemen improvementt in performance, this is it”. it”. Jim Duffy, NHS Tayside

If you would like to see more from Vanguard Scotland on making improvements improvements in customer orientated systems, why not sign up to our free blog with regular tips, advice and giveaways at  at www.systemsthinkingmethod.com/bl og-welcome me   www.systemsthinkingmethod.com/blog-welco

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