QI 1279 Reducing Waits for Review in Children’s Speech and Language Therapy Mainstream

Abstract

Aim: To reduce length of wait for follow up review assessment within school age caseload (mainstream schools, non-EHCP service) by 30%.

This project was carried out to address the waiting time for follow up (review) assessment in the Mainstream schools (non-EHCP) caseload in Children’s SLT. The project started in June 2023 when the wait for a follow up assessment was beginning to increase, the longest wait being 28 weeks. 1.5 days per week clinical time was taken up by band 6 SLTs managing 6 separate Mainstream caseloads (11hrs per week). A number of change ideas were tested and implemented to streamline the caseload and caseload management system, introduce an opt in system for parent/carers, consider the use of diary sheets for admin staff to book directly into, and considering how both SLTs and SLTAs worked within the sessions. These changes overall helped maintain and then reduce the wait time for a follow up assessment. It is important to note that other changes within the service (external to this project) have also had a positive influence on the wait times and overall size of the caseload, these included the introduction of a language package of care (throughput model) and an unusually low opt in rate over summer 2024. Monitoring of the data has allowed for the impact of these changes to be observed. Having one overall shared database for the entire Children’s SLT caseload helped with data collection and oversight of the caseload.

Tools Used: Process Map - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-conventional-process-mapping.pdf; Understanding the problem; Stakeholder Engagement - www.aqua.nhs.uk/wp-content/uploads/2023/07/qsir-stakeholder-analysis.pdf; PDSA - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf; Measurement - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-measurement-for-improvement-overview.pdf.

Project Impact: A more consistent and standardised approach in dealing with queries from schools and parents. Reduction in unnecessary appointments for children who don’t require one. Aligns the process with the rest of the service. Caseload size has reduced and then remained fairly static (even over the month of September when there is usually a large influx of preschool transfers).