Delivering the 18 Weeks Referral to Treatment Standard Output Report

during a return outpatient appointment. This is to be encouraged, but in manyinstances, current reporting systems mean that these treatments are not recorded aspart of the activity. Similarly currently they do not always ‘stop a clock’ as part ofmeasuring patient waiting times.One of the key challenges to these specialties therefore, is capturing and measuring,and then delivering all elements of the patient journey. This should facilitate anunderstanding and management of the true stage of treatment waiting times in orderto make progressive improvements to reducing waiting times.By reducing the component parts of the patient journey (i.e. outpatients, inpatients,daycases), achievement of the whole pathway, from receipt of referral to the start ofdefinitive treatment, within 18 weeks becomes more manageable. It is this deliveryrequirement that the Task and Finish Group has focused upon, across all thespecialties, and continue to address the identified risks to delivery and theconsequent challenges and opportunities as a core part of its outputs.Identified Risks to DeliveryFrom its inception, the Task and Finish Group highlighted a range of challenges forearly consideration:1. Long waiting times in some dental specialties.2. Interface between primary and secondary care and the financial drivers that canaffect this.3. Variations in referral practices and differing treatment pathways across the caresettings for a single condition (e.g. simple extraction of tooth).4. Variations in referral thresholds, especially for orthodontic treatments.5. Establishment of robust data collection and reporting systems to proactivelymanage dental specialties and associated waiting times.6. Uniform application of the definitions to ensure consistent and accurate recordingof patient journey times.7. Hidden waits for treatments undertaken in the outpatient setting which were notpreviously measured.8. Workforce considerations and further use of enhanced practitioner roles.9. Organisational profile and integration of dental specialties into waiting timesmanagement processes.Priority Task and Finish Group Improvement ActionsAs part of the methodology for minimising these risks, the Dental Specialties Taskand Finish Group identified the following priority actions for the Group:Dental Specialties Task & Finish Group – January 2011 11