Active Clinical Referral Triage (ACRT)

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Active Clinical Referral Triage endorsed challenge - latest update

Challenge Overview

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

Supporting Outpatient Clinical Workflows - Covid 19 Update

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.


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

Please Contact for further information if required

ACRT and Patient Initiated Returns (PIR) Checklist

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

It is available to download here.