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As such, once patients are referred to the Orthotic Service, they are very likely to require access to the service on a long term or lifelong basis. ) /Pg 7 0 R /K [7] >> endobj 21 0 obj << /Type /StructElem /S /P /E (In September 2021, the waiting time for an Orthotics Routine New Patient was over 78 weeks with approximately 1900 patients on the list. The team agreed to undertake pathway redesign work as part of The NHS Lothian Outpatient Redesign Programme, which aligned to The Scottish Collaborative and Modernising Patient Pathways Programme.) /Pg 7 0 R /K [8] >> endobj 22 0 obj << /Type /StructElem /S /Figure /P 13 0 R /Pg 7 0 R /K [50] >> endobj 23 0 obj << /Type /StructElem /S /P /E (AIMS) /Pg 7 0 R /K [23] >> endobj 24 0 obj << /Type /StructElem /S /P /E (METHOD) /Pg 7 0 R /K [29] >> endobj 25 0 obj << /Type /StructElem /S /P /E (The team engaged with NHS Lothian TRAK redesign team and agreed its requirements. Every member of the clinical and admin teams were allocated to a working group. All work was lead and overseen by the Orthotics Team Lead, and staff were empowered to make decisions on behalf of the wider team and service. Staff were allocated time every week to undertake the work required. ) /Pg 7 0 R /K [24 25] >> endobj 26 0 obj << /Type /StructElem /S /P /E (Each working group updated and fed back to the wider team monthly. ) /Pg 7 0 R /K [26] >> endobj 27 0 obj << /Type /StructElem /S /P /E (The service introduced clearly defined Patient Initiated Follow Up \(PIFU\) allowing patients to re-engage directly with the service when required by either completing an online or paper form. ) /Pg 7 0 R /K [27] >> endobj 28 0 obj << /Type /StructElem /S /P /E (Planned Repeat Pathways were clearly defined so that only patients with a clear clinical reason or who lacked robust support to re-engage were given follow up review appointments. ) /Pg 7 0 R /K [28] >> endobj 29 0 obj << /Type /StructElem /S /P /E (Remote Appointments were trialed to establish what patients were appropriate for remote clinics. 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endobj 58 0 obj << /Type /StructElem /S /P /P 111 0 R /E (The team produced ACRT documentation with clearly defined guidance to ensure consistency in triage and allocated fixed time for senior clinical staff to triage daily to ensure timely management for clinically urgent patients. ) /Pg 7 0 R /K [33 34] >> endobj 59 0 obj << /Type /StructElem /S /P /P 112 0 R /E (Remote consultations resulted in over 700,000 miles saved in travelling to face-to-face appointments since January 2021. ) /Pg 7 0 R /K [35] >> endobj 60 0 obj << /Type /StructElem /S /Figure /P 13 0 R /Pg 7 0 R /K [54] >> endobj 61 0 obj << /Type /StructElem /S /P /E (REFERENCE) /Pg 7 0 R /K [48] >> endobj 62 0 obj << /Type /StructElem /S /Figure /P 13 0 R /Pg 7 0 R /K [49] >> endobj 63 0 obj << /Type /StructElem /S /Figure /P 13 0 R /Pg 7 0 R /K [55] >> endobj 64 0 obj << /Type /StructElem /S /P /E (Before Redesign) /Pg 7 0 R /K [44] >> endobj 65 0 obj << /Type /StructElem /S /P /E (After Redesign) /Pg 7 0 R /K [45] >> 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