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From blacklist to beacon, a case study in reducing dermatology out-patient waiting times

Lookup NU author(s): Dr Clifford Lawrence


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At its worst our dermatology department had a waiting list for routine appointments of 57 weeks. As a result we started to lose contract income and consequently were unable to replace a retiring consultant. The service faced fragmentation and loss of the inpatient ward. Using a series of internally planned and driven initiatives it was possible to retrieve the situation. Our efforts were recognized by a national waiting list Beacon award in 1999. This study describes the methods used to increase new patient throughput, reduce demand and hence reduce waiting time for new patient appointments. Change was achieved only when medical, nursing staff, general practitioners, managers and health authorities were involved in the process. The changes needed to be led by a consultant enthusiast and managed effectively. There remains a constantly increasing demand for the service and reducing the waiting list simply invites a further increase in referral. In a resource-limited health care system the provider must be able to limit demand by using agreed referral exclusion criteria in order to balance supply and demand.

Publication metadata

Author(s): Appleby A, Lawrence C

Publication type: Review

Publication status: Published

Journal: Clinical and Experimental Dermatology

Year: 2001

Volume: 26

Issue: 6

Pages: 548-555

ISSN (print): 0307-6938

ISSN (electronic): 1365-2230


DOI: 10.1046/j.1365-2230.2001.00887.x