Through this year’s Q Exchange, we had 120 proposals for improvement projects all aimed at reducing delays accessing health and care services. So, we wanted to know: can these proposals tell us something more about system pressures? What are the priorities of the community on this issue? And which solutions for reducing delays are emerging?

When submitting their projects, the teams selected ‘areas of interest’ that their projects connected with. The five most commonly selected areas of interest reflect some priorities of the health and care system in the UK and Ireland: access (45), inequalities (28), quality improvement (27), patient experience (24) and person-centred care (22).

While 28 teams chose ‘inequalities’ as an area of interest, more teams referred to tackling health inequalities in some way in their proposal. Only a handful had reducing inequalities as a critical aim for their project.

Within the overarching theme of reducing delays in accessing care, different goals emerged:

• Improving efficiency in pathways such as A&E redesign and improving flow
• Reducing diagnosis waiting times, including MRIs
• Increasing the use of existing services and reducing DNAs (‘Did Not Attend’)
• Increasing capacity, people and resources to reach more patients
• Reducing demand, including referrals, admissions, and calls
• Focusing on prevention, including earlier interventions
• Improving the way waiting lists are managed
• Supporting patients to ‘wait well’

Project proposals were spread evenly over 30 clinical specialities, and some cut across all of them. Paediatrics and psychiatry were the popular outliers, with 10 and 8 proposals, respectively, while the other 28 specialities had 1 to 4 projects each. This could reflect the reality that there are delays in all areas of the health and care system.

But the clinical speciality didn’t dictate the type of tools and methods adopted for the challenge. These are some of the most prominent themes we identified in the proposed solutions, with some examples highlighted:

Streamlined care through hubs, cafés, and one-stop-shops

• A one-stop clinic for children and young people with suspected asthma, bringing together diagnostics, holistic assessment and shared learning
• A Medicines Cafe where older people can discuss medicines in a community-based, non-clinical environment
• A new Health Hub and Health Hub Specialist to streamline care in a GP practice

Maximising care at home and in the community

• A Neighbourhood based Primary Care Menopause Clinic to support women going through the menopause
• A mutlidisciplinary virtual ward for managing chronic musculoskeletal pain
• A Home Ventilation Service to improve access to specialist health care for patients who are unable to attend hospital appointments

Technology and digital tools

• Expanding the use of artificial intelligence in radiology diagnosis
• Testing an automated process to review blood pressure readings
• A custom-made splint to enable remote monitoring of finger range following hand trauma or surgery

Co-production and co-design with patients

• Co-designing interventions to optimise patient’s health so they are fit for surgery
• Co-producing an approach to ‘waiting as well as possible’ for psychological interventions
• Co-designing a health and wellbeing drop-in centre for young people

Cross-sector integration

• A patient-centred pain management journey that spans community and secondary care
• Evaluating an integrated ambulance community response service
• Working in partnership with education colleagues to improve access to support for children with motor coordination difficulties
• A Neighbourhood-level, cross system approach to reviewing community rehabilitation referrals and waiting lists

Upskilling staff

• Training new practitioners in parent-infant therapy services to increase access
• Educating health professionals about weight management pathways to reduce health tourism and its consequent complications
• Upskilling teams to use data to understand demand and capacity, and to use QI methods to identify and test different ways of working

Enabling peer support to

• Improve antenatal mental health and awareness
• Ease the transition to adult care for young people with diabetes
• Support young people with rheumatic diseases

All 120 proposals demonstrated the creativity and innovation of the Q community. Even some of the titles were impressive in this respect. ‘Doing It For The Kids’ and ‘From jabs to tabs’ were two of our favourites. What is clear from this round of Q Exchange, as always, is the commitment to finding new ways to improve care and outcomes for people across the UK and Ireland. The Q Exchange proposals are only a small proportion of all the work across the UK to reduce delays. Nonetheless, they provide some insight into the issues in accessing services and many ideas about how they could be addressed.

The final 20 funded projects will soon be starting. They will be updating their project pages at different points throughout their award. You can follow how project delivery is progressing, lessons learned and opportunities to collaborate by visiting project pages for updates.