Since my early days as a newly qualified physiotherapist, the issue of waiting lists has been a constant challenge. I vividly recall the frustration of watching patient cards pile up, a stark reminder of the overwhelming demand we faced.
Even with the advent of electronic systems that simplified tracking, the problem persisted. Despite our efforts to work harder, optimise pathways and implement group sessions, capacity never matched the ever-growing demand.
The promise and complexity of Community Appointment Days
When I first encountered the concept of Community Appointment Days (CADs), I was enthusiastic. The idea seemed like a game-changer, a solution that should be adopted universally. However, as I learned more, I realized the depth of the processes involved in making these days successful.
At a recent lunch and learn hosted by the Q community, Laura Finacure and Adam Lent provided valuable insights into the development and success of these events, while Biance Vegas and I enjoyed asking them lots of questions. The full recording (see link below) is well worth a listen.
It shares the story of how a physio service used these alongside a strengths-based, community-orientated approach to cut waiting list times by a third.
Here are my key takeaways.
1. Efficiency alone doesn’t work
‘The only way we are going to solve the waiting list problem is by getting rid of the idea of solving this through being more efficient.’
This statement, shared during the session, underscores a crucial point. Despite efforts to streamline processes and reduce wait times, the sheer volume of demand means that efficiency improvements alone are insufficient.
Long waiting lists lead to poorer health outcomes, particularly for musculoskeletal (MSK) health, where timely intervention is critical.
Laura and her team have embraced a personalised approach to patient care, asking each patient, ‘What matters to you?’ This shift has naturally evolved into the development of CADs.
By assessing community needs and leveraging available NHS and third-sector services, they created a holistic approach where patients could access comprehensive MSK care in one place.
The immediate impact on waiting lists was a testament to the power of a community-powered, strengths-based programme.
Better care, not just more efficient care, is essential to addressing both short-term financial pressures and long-term demand.
2. Put process over product
Avoiding the ‘shift and dump’ mentality—where CADs are imposed on unprepared services—requires starting with conversations.
Engaging with patients, staff and other service providers to understand needs is fundamental. Laura emphasised the importance of setting aside our egos to be truly receptive to new ideas and outcomes.
This approach demands flexibility and collaboration, tailoring responses to specific community needs.
Different teams have varying levels of experience and readiness for delivering innovative care. Some may need to begin by engaging with patients and local services to determine the best approach.
Adam shared an example of a CAD that failed because it was implemented without considering the community’s unique needs. The lesson? Successful CADs are built on understanding and adapting to local contexts.
3. Lead with humility and attention to detail
Effective leadership in health care improvement hinges on humility and attention to detail.
Leaders must be equal partners with their patients and teams, acknowledging that they don’t have all the answers.
Incorporating diverse perspectives from outside our clinical professions, or even outside healthcare, can enrich understanding and solutions.
Granularity emerged as a key theme in behaviour change. Detailed attention to daily habits and rituals can drive significant organisational and cultural shifts towards a preventative, strength-based approach.
Allied health professionals (AHPs) possess transferable skills in coaching healthy behaviours, helping patients integrate new routines. Similarly, leading change involves supporting teams to foster a culture of improvement and collaboration through examining their practices and assumptions.
Learn more and get involved
For practical insights into how a physio service cut waiting list times by a third by using a strengths-based, community-orientated approach, watch our YouTube recording.
You can also read Adam’s blog and watch his interviews on the New Local website.
For more insights into organising Community Appointment Days, listen to the Physio Matters Podcast.
To hear their latest updates and ideas, connect with Laura Finucane and Adam Lent on LinkedIn.
Embracing these lessons and approaches can transform health care from a burdensome system into a responsive, collaborative journey that works with people, rather than doing to them.
Share your views in the comments below.