Client Background
West Suffolk NHS Trust sought to improve the efficiency of their dermatology patient pathways. The focus was on reducing waiting lists, ensuring timely follow-ups, and discharging patients whose pathways were complete, all while maintaining high standards of care.

Challenge
The dermatology PTL (Patient Tracking List) initially contained 4,566 patients, creating significant pressure on staff and risking delays in patient care. Multiple overlapping pathways, discharges, and clock stops required a coordinated approach to meet NHS planning targets, including 18-week referral-to-treatment standards.

Solution
A team-led approach was implemented, combining the efforts of PRMC, nursing staff, and consultants. Key actions included:

• Daily PTL reviews to identify and remove patients whose pathways had closed.
• Focused discharges of patients who did not respond within three weeks to contact requests for an OPA (Outpatient Appointment).
• Following Dr. Chen’s guidelines for managing first OPAs, discharges, and clock stops.
• Coordinated handling of follow-ups and referrals to ensure minimal delays.

Results
The impact over six weeks has been measurable:

• PTL Reduction: The PTL was reduced from 4,566 patients to 3,549, bringing the caseload closer to operational targets.
• 18-Week RTT Performance: Improved from 46.0% to 53.6%, moving above target performance.
• Patients Over 52 Weeks: Reduced from 507 to 189, indicating faster treatment and pathway closure.
• Patients Over 65 Weeks: Reduced from 157 to 56, eliminating long-wait outliers.
• Efficient Clock Management: Daily monitoring of clock starts and stops ensured accurate tracking of patient pathways.

These results highlight how a structured, collaborative team approach, combined with adherence to clinical guidelines, significantly improved patient flow and reduced waiting list pressures.

At West Suffolk, we’ve seen equally strong results. At the end of June, the PTL was in a tough place:

• 18 weeks: 46.0% (against a 47.9% target)
• 52 weeks: 493 patients
• 65 weeks: 93 patients

Fast forward to mid-September, and through consistent daily focus, teamwork, and shared accountability, we’ve achieved:

• 18 weeks: 53.6% (exceeding the 49.9% target)
• 52 weeks: reduced to 189 patients (on track for year-end goal of 108)
• 65 weeks: reduced to 56 patients (on course to reach 0 by year-end)

Conclusion
Through diligent coordination and proactive management, West Suffolk’s dermatology PTL has achieved measurable improvements in efficiency and compliance with NHS England targets. This demonstrates the value of a focused, team-led approach in managing complex patient pathways.