PT  - JOURNAL ARTICLE
AU  - Amar Shah
AU  - Auzewell Chitewe
AU  - Emma Binley
AU  - Forid Alom
AU  - James Innes
TI  - Improving access to services through a collaborative learning system at East London NHS Foundation Trust
AID  - 10.1136/bmjoq-2018-000337
DP  - 2018 Jul 01
TA  - BMJ Open Quality
PG  - e000337
VI  - 7
IP  - 3
4099  - http://bmjopenquality.bmj.com/content/7/3/e000337.short
4100  - http://bmjopenquality.bmj.com/content/7/3/e000337.full
SO  - BMJ Open Qual2018 Jul 01; 7
AB  - Early intervention following initial referral into healthcare services can have a significant impact on the prognosis and outcomes of patients. Long waiting times and non-attendance can have an immediate and enduring negative impact on patients and healthcare service providers. The traditional management options in reducing waiting times have largely revolved around setting performance targets, providing financial incentives or additional resourcing. This large-scale quality improvement project aimed to reduce waiting times from referral to first appointment and non-attendance for a wide range of services providing primary and secondary care mental health and community health services at East London NHS Foundation Trust (ELFT). Fifteen community-based teams across ELFT came together with the shared goal of improving access. These teams were diverse in both nature and geography and included adult community mental health teams, child and adolescent mental health services, secondary care psychological therapy services, memory services, a musculoskeletal physiotherapy service and a sickle cell service. A collaborative learning system was developed to support the teams to come together at regular intervals, share data, test and scale-up ideas through quality improvement and have access to coaching from skilled improvement advisors in the ELFT central quality improvement team. Over the course of the 2-year project, waiting time from referral to first face-to-face appointment reduced from an average of 60.6 days to 46.7 days (a 23% reduction), non-attendance at first face-to-face appointment reduced from an average of 31.7% to an average of 20.5% (a 36% reduction), while referral volume increased from an average of 1021 per month to an average of 1280 per month (a 25% increase).