and Tower Hamlets integrated their teams to create one waiting list per borough . This had the added benefit of improving cover for annual leave / sickness absence , reducing isolated working , and standardising processes , thereby reducing variation in care .
Outcomes
Through their efforts , the Bedfordshire team was able to see almost all patients on time , reducing its 18-week breaches from 4.11 % to 0.5 % per month – an 88 % decrease ( Gillett et al 2024 ).
The Newham team has successfully reduced the number of people waiting longer than six weeks from 31 to three per month – a 90 % decrease – and continues to test change ideas so that all patients are seen on time .
Zahra Famurewa , Lead Community Therapy Therapist in Newham says : ‘ We are proud that Newham residents are now prioritised by need rather than by postcode , and all referrals are screened on time .’
The team in Tower Hamlets reduced the number of people waiting longer than six weeks by 89 %, from an average of 111 to 12 people per month . The team has noticed an improvement in staff satisfaction , as well as improved recruitment and retention .
Staff have fed back that they feel there is better clinical oversight , that senior occupational therapists and physiotherapists now have more clinical time , and that communication with the admin team has improved .
Key learning
Using a Quality Improvement approach supported teams to review their processes and identify areas for improvement .
Eleanor Gillett , Therapies Clinical Service Manager in Bedfordshire , reflects : ‘ Involving the team in the quality improvement process empowered staff to identify and solve problems , fostering a sense of ownership and collaboration .
‘ The successful implementations were highly motivating , as staff could see their contributions leading to tangible improvements .’
Introducing successful changes required constant ‘ tweaking ’ of ideas as they were tested in different environments . With variation in how each locality worked , teams responded differently to proposed changes .
Project leads played a vital role in supporting this change by keeping staff informed and working with them to understand the need for changes .
Regularly reviewing their waiting list data to learn where to prioritise their efforts and determine the impact of their change ideas .
Tower Hamlets Therapies Pathway Manager Above : Tower Davinder Kaur explains : ‘ Before the project , we Hamlets were receiving data from our performance team , Community Therapy Team but we weren ’ t consciously utilising it . Now we review our data about longest waiters and breaches weekly and prioritise those patients when booking appointments .
‘ This gives us the bigger picture of where things are not going so well , so we can make improvements . That has really helped me to manage our service better .’
Bennett B and Provost L ( 2015 ) ‘ What ’ s Your Theory ?’, Quality Progress . Available at https :// tinyurl . com / yzhdyw64 [ accessed 25 November 2024 ].
Gillett E , Hughes L and Collins M ( 2024 ) ‘ Reduction in 18 + weeks breaches for community occupational therapy and community physiotherapy in Bedfordshire Community Health Services ’. Available at https :// tinyurl . com / 2p8d4w5d [ accessed 25 November 2024 ].
Langley GJ , Moen RD , Nolan KM , Noland TW , Norman CL and Provost LP ( 2009 ) The Improvement Guide ( 2nd ed ). San Francisco : Jossey-Bass
Words DAVINDER KAUR , OT and Therapy Pathways Manager , Community Therapy Team , Tower Hamlets , East London Foundation Trust , and QI coach ; CLARISSA SØRLIE , OT and Improvement Adviser , East London Foundation Trust ; and WILL DIAZ , Nurse and Improvement Adviser , East London Foundation Trust . With thanks to Christopher Harvey , Eleanor Gillett , Louise Hughes , Megan Colins , Nizamul Hoque , Prabhakar Subramani and Zahra Famurewa for their contributions
January 2025 OTnews 31