Driving improvement, delivering results: healthcare science national delivery plan 2015–2020

3 Improvement programme for demand optimisation

Why this matters

Demand optimisation is defined as the application of processes and tools to maximise the "return" of effectiveness of healthcare science interventions, consequently freeing-up capacity, particularly in the life sciences stream (Fryer & Smellie, 2013; Knowles & Barnes, 2013). Basically, it is about providing the right test at the right time to the right person in the right way, reducing or eliminating unnecessary testing and enhancing decision-making in patient care.

Anecdotally, work of this nature is going on locally in NHSScotland, but there is no hard evidence on which to base an overview of areas of good and bad practice or variability in approaches. Evidence and best practice are required to optimise investigation usage, as appropriate testing may avoid patients having to access hospital services and improve patient outcomes.

Current situation

Some NHS boards are reporting a 15% year-on-year increase in diagnostic testing activity and associated costs, but the review of pathology services in England (Department of Health, 2008) estimates that around 25% of diagnostic tests currently undertaken are inappropriate. This significant waste impacts on patient pathways and experiences, increases service workload and consumes precious resources. Variation in practice at NHS board level is evident across a range of variables, including costs, quality and patient experience.

Our ambitions

We want to:

• reduce unnecessary testing
• free capacity to address rising demand
• reduce hospital referrals and admissions by developing robust preventive testing that promotes primary care delivery.

Deliverable 3

To achieve our ambitions, NHS board healthcare science leads will work with stakeholders to develop local improvement plans to reduce unnecessary testing across primary and secondary care. This will free-up capacity to address rising demand and deliver testing that positively affects the patient pathway, supports primary care preventive measures and reduces hospital referrals and admissions. This will be achieved by the end of 2017, with full implementation by the end of 2019.

Achieving Deliverable 3

NHS boards will:

• support healthcare science leads, managers and heads of service to work with the national healthcare science leads and diagnostic networks in collectively progressing this improvement work.

National healthcare science leads, NHS board healthcare science leads, managers and heads of services will:

• work with NHS boards and diagnostic networks to reduce unnecessary testing and measure overall impacts on patient outcomes.