Active Clinical Referral Triage (ACRT)

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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.

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
ACRT Complete Toolkit

Active Clinical Referral Triage (ACRT) and Patient Initiated Return (PIR) Toolkit

An ACRT Toolkit been produced to help NHS Boards implement their ACRT and PIR requirements. A PDF version of the toolkit is available to download below.

Outpatient Support Resource

Supporting Outpatient Services during COVID 19

The following advice is offered to services to alleviate patients’ anxiety and to identify those in greatest need of ongoing planned care. Please download the document below.

Contact us

For support with ACRT and PIR or with any of the above, please contact:

Margaret Wood, National Improvement Advisor,  Modernising Patient Pathways Programme  

Lech Rymaszewski, Clinical Advisor, Modernising Patient Pathways Programme 

To contact the MPPP/SAC team, please email us at


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Please follow us and use hashtags #ACRTScot and  #PIRScot when tweeting about this work.