Ensuring that all referrals to secondary care (including advice and patient-led referrals) are triaged by a senior clinical decision maker to evidence-based, locally agreed pathways after reviewing all the  appropriate electronic patient records. The options include virtual attendance, giving patients clinical information and allowing them to opt-in, ordering investigations, placing on a waiting list for a procedure / surgery and face-to-face (F2F) appointments.  For more information on the difference between a Traditional Pathway and a Modernised Patient Pathway, please see the attached document  

Planned Outcomes

• Outpatient (OP) waiting lists should only include patients who clinically require a face-to-face (F2F) attendance with a healthcare professional.
• Release of resource from existing processes to support moving to ACRT – especially replacing the time clinicians use to see patients F2F unnecessarily with an allocation for ACRT in their job plans.
• Shorter time to diagnosis and treatment, with better informed patients.
• Increased staff and patient satisfaction, improvement in clinical outcomes.
• Using Waiting List Validation outcomes to update current care pathways, and for advice/guidance to primary care teams.
• Improved service planning assumptions and outputs

Key Milestones

• Connections Event August 2018
• Chief Executives endorsement December 2018
• Minimum Dataset agreement January 2019
• Initial Dataset return February 2019
• Cost analysis of an ACRT pathway April 2019 (Knee at GRI)
• Update to Chief Executives June 2019 - view the presentation here
• 6 Month data review and impact analysis August 2019

Strategic Links

• EQuIP
• Clinical Pathways Infrastructure
• Realistic Medicine

Challenge quantifiable results

Early data from the 58 pilot sites underway have indicated that ACRT can reduce the need for face-to-face appointments by between 15 and 35%

Delivery Leads

Margaret Wood, Modernising Patient Pathways Programme and Lech Rymaszewski, Clinical Lead

Routine outpatient clinics are being scaled back in response to COVID-19.  The Supporting Outpatient Clinical Workflows document provides some information around oportunities to support priority clinical workflows.

A toolkit has been produced to help Boards implement this challenge.  The complete toolkit  is available as a pdf.

Please Contact Margaret.Wood@gov.scot for further information if required

An implementation checklist for ACRT and PIR has been created for use within Boards.

It is available to download here.