Scottish Government
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Improving flow of patients

£4.5m to test two innovative models of healthcare.

Two groundbreaking models are to be tested by Scottish health boards to help improve the flow of patients through the NHS.

The approaches will look at improving the way that patients move through the hospital system, with the aim of freeing up beds, and reducing the amount of time that patients spend unnecessarily in hospital.

NHS Lanarkshire and NHS Forth Valley will be the first health boards to pilot the approaches, with another three health boards, NHS Greater Glasgow and Clyde, NHS Tayside and NHS Borders to follow.

The models are being funded by £4.5 million of investment over the next three years.

The pilot in NHS Forth Valley has already been successful and has dramatically reduced waiting times in hospitals in the USA and Canada, such as Cincinnati Children’s Hospital in Ohio, and the Ottawa Hospital in Ottawa, Ontario.

If they prove effective, this work will then be rolled out to other health boards across Scotland.

Health Secretary Alex Neil said: “I have been very clear that we need to improve the way that patients flow through our hospitals, and these innovative models will help to test new ways of improving how the NHS operates.

“I am keen that Scotland can continue to lead the way in pioneering work to improve care for our patients, and this work will help to ensure that health boards are managing their capacity and ensuring that patients are not kept in hospital unnecessarily.

“Improving flow throughout the whole system will help to free up beds and ensure patients can be put in the most appropriate ward for their treatment.

“This also feeds into the work we are already doing around ensuring we can offer consistent round the clock care to patients across Scotland.

“I know that changes towards 24/7 care are already happening in some areas, but we need to accelerate the pace of change, by targeting enhanced weekend and out of hours services that will benefit patients the most, and that is why I have also appointed an expert group to look specifically at this issue.

“In addition, we have invested £50 million in our unscheduled care action plan which is making improvements to the whole healthcare system to ensure patients can be seen and treated quicker.”

Dr Peter Murdoch, Medical Director, NHS Forth Valley, said: “We are delighted to be involved in this project which aims to ensure patients get the right care, at the right time in the right place.

“We are bringing together a local team to work with colleagues from the Institute of Healthcare Optimisation in Boston to help shape and support this important initiative and explore how we can use their experience to help further improve the way we design and deliver services in Forth Valley.”

Notes to editors

NHS Forth Valley will pilot a model pioneered by the Institute of Healthcare Optimisation (IHO) which is led by Professor Eugene Litvak.

The approach has already been successful and has dramatically reduced waiting times in hospitals in the USA and Canada, such as Cincinnati Children’s Hospital in Ohio, and the Ottawa Hospital in Ottawa, Ontario.

In Cincinnati Children’s Hospital, after adopting this model, weekday waiting times for emergency surgery decreased by 28 per cent, despite an increase in case volume of 24 per cent. In addition, weekend waiting times for emergency surgery fell by 34 per cent, despite an increase in activity of 37 per cent.

The Ottawa Hospital improved access for patients needing emergency surgery within 24 hours from 60 per cent to 90 per cent.

It is based on improvement methodologies which have already been used to improve the way people flow through airports and supermarkets.

This approach aims to separate emergency and elective activity, as it recognises the different approaches that are needed to predict and manage the two types of activity.

Elective activity will fluctuate more from day to day, while emergency activity is more constant.

The aim of the work is to help smooth the flow of elective activity throughout the week, to avoid peaks and troughs in activity.

Once tested in NHS Forth Valley, this approach will then be phased in across NHS Greater Glasgow and Clyde, NHS Tayside and NHS Borders.

In addition, NHS Lanarkshire will test a ‘Flow Cost Quality’ model which has been pioneered in England and Wales and is led by Dr Kate Silvester.

This model will focus on mapping patient flow through hospitals, analysing the patient journey, and testing small changes to monitor the impact on patient flow.

It involves engaging with clinical and management staff to understand the types of issues that can affect the throughput of patients through the hospital, such as boarding of patients and delayed discharge rates.

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