1. The Modern Outpatient 90 Day Challenge
NHS Greater Glasgow & Clyde January 2018

2. GGC Outpatients 20
Adult OPDs
380,000
New OPs
780,000
Return OPs

3. The scale of the challenge

4. Funded projects
General Surgery: See and Treat clinics Urology: Nurse-led Bladder Dysfunction clinic Urology: Andrology clinic Respiratory: AHP-led PE/DVT service Neurology: Nurse-led Headache clinics Neurosurgery: Spinal Surgery clinics

5. -5 % -3 % General Surgery 5 year trend 1 year trend
New Outpatients,
5 year trend
-5 %
1 year trend
-3 %

6. General Surgery See and treat clinics
Patients from South Glasgow with excessive waits for hernias and lumps/bumps, inc POA and return appts to be seen in evening clinics at Glasgow Royal Infirmary
Diagnostic and inpatient costs to be funded locally
13 weekly Monday evening clinics
2 Consultants x 12 patients each
312 patients
Staffing per session: 2 Consultants, 2 Band 5 Nurse, 1 Band 2 Nurse 
Cost £20,800

7. General Surgery See and treat clinics
30 patients already attended clinics in week 1 42 patients booked into weeks 2/3 330 further slots left to be booked until the end of March. 32 patients removed through the process of making contact to offer slots and patients advising the appointment is no longer required

8. Urology
New Outpatients,
5 year trend
2 %
1 year trend
0 %

9. Urology Nurse-led bladder dysfunction clinic
Weekly nurse led bladder dysfunction clinic for new Urology patients
This patient group is currently being seen exclusively at consultant clinics, therefore this will release new appointment slots on consultant clinics for more specialist work/USOC referrals
1 clinic per week over 12 weeks patients
Band 6/7 Nurse, with consultant supervision for first four clinics
Cost £4,900

10. Urology Nurse-led bladder dysfunction clinic
Vetting processes agreed and amended Clinical protocols developed First four clinics are on Trak and 64 patients have been vetted into them

11. Urology Additional andrology clinics
This has been identified as a specific area of pressure with patients waiting over 12 weeks to appointment due to having only one consultant offering this sub-specialism (and lack of services in surrounding NHS Boards)
1 clinic per week
15 slots per clinic
180 patients
Consultant session
Nursing support and sundries
Cost £11,000

12. Urology Additional andrology clinics
15 additional clinics booked on Trak Patients for first four clinics have been confirmed Slight increase in WL from 62 (Dec) to 70 (Jan) Average waiting time has reduced from 103 days (Dec) to 64 days

13. 11 % -4 % Respiratory Medicine 5 year trend 1 year trend
New Outpatients,
5 year trend
11 %
1 year trend
-4 %

14. Respiratory Medicine DVT/PE Nurse Practitioner clinic
Develop the DVT/PE service to reduce wait for new patients
Medical Nurse Practitioner clinic to be established to run in parallel with consultant clinic to reduce wait for patients and free up consultant slots for more complex work
15 clinics
8 patients per clinic
120 patients
Band 7 MNP
Cost £4,900

15. Respiratory Medicine DVT/PE Nurse Practitioner clinic
Additional clinics set up on Trak Medical staff in place for parallel clinics Service postponed to start in Feb due to illness of appointed postholder

16. 23 % 2 % Neurology 5 year trend 1 year trend
New Outpatients,
5 year trend
23 %
1 year trend
2 %

17. Neurology Nurse-led Headache clinics
Due to a recent retiral and absence headache, patients are waiting longer than clinically indicated for headache treatments (injectable therapies)
This will allow patients to be vetted, seen and treated by an experienced CNS
3 clinics per week
6 patients per clinic
216 patients
Band 7 CNS
Cost £6,000

18. Neurology Nurse-led Headache clinics
4 injection clinics per week have been established Backlog of new patients waiting for first appointment and assessment has been fully appointed 24 patients seen in weeks 1-2

19. 40 % -6 % Neurosurgery 5 year trend 1 year trend
New Outpatients,
5 year trend
40 %
1 year trend
-6 %

20. Neurosurgery ESP/Consultant Spinal Surgery clinics
Due to increasing demand and a recent absence, OP waits for spinal surgery have increased 
Patients will be seen in weekend clinic either by Spinal ESP (1) or consultant (3), as per vetting
4 clinics per week
6 patients per clinic
288 patients
Band 8A ESP
3 consultants
Cost £25,000

21. Neurosurgery ESP/Consultant Spinal Surgery clinics
30 patients already attended clinics in weeks 1/2 36 patients booked into weeks 3/4 Further clinics being arranged for Feb and March No patients removed through the process of making contact to offer slots, as the service had already undertaken a telephone clean-up of all patients with long waits