Transforming Outpatient Services Primary drivers Change concepts Aim All people are seen in the right place, at the right time, by the right person. Initial Measures Decrease new appointments by 10% Decrease return:new ratio, achieve Scotland upper quartile follow up Decrease DNAs to 4% People attend OP clinics as last resort (Reduced return:new) (Reduced unwarranted first appointments) (Improved referral outcome) Adopt Advice Only, clinical dialogue and referral feedback response Standardise multidisciplinary triage approaches including centralised and etriage Clinic resources are fully utilised (Reduced DNAs) (Reduced clinic cancellations) Reduce DNAs by utilising reminder systems Adopt direct access to imaging for knees through Orthopaedics, Radiology and GP redesign More people are assessed at home or in the community (Reduced variation in referral and return) (Reduced waits) (Increased self management) Roll out direct access to community physiotherapy (knee and lower back), and consider use of NHS24 capacity Enabling Our 2020 Vision Invention and innovation – including embedding use of technology Leadership and clinical behaviour change Use of data and measurement Knowledge into action Improving flow and capacity management April 2013