Reducing waits in elective care
How can we work together to reduce waiting times for elective care? Q Lab helped four health care teams to tackle the challenge in new ways.
Q Lab brought people together between August 2023 and May 2024 to explore how we could create collective responsibility to reduce delays in elective pathways. Five test teams applied the process to challenges in their settings, with positive results.
Background to the Lab
Our topic for the Q Lab in 2023/24 was: how can we create collective responsibility to reduce delays in elective pathways?
Waiting lists and wait times for NHS elective care are at unsustainable levels. Timely, efficient, and safe care relies on collaboration and flow along pathways. There’s already good work going on across the health system, but pressures on the system can get in the way of solutions and shared ownership of the problem.
We have been working with members on the issues of waiting lists and access to care for several years. Q Lab offers a proven approach to working together to make progress on complex health and care challenges like this.
What we did
The Lab began in August 2023 and worked together over nine months to explore, learn, innovate and test around the topic of reducing delays in elective pathways.
Test teams
From applications to join this Q Lab, we selected and provided funding to four test teams looking to participate to help tackle specific challenges in their settings.
- Aneurin Bevan University Health Board, Wales. Wanted to reduce waits for people suspected of having head or neck cancer.
- South Docs Services. Sought to improve the flow of patients through the urology pathway across Birmingham.
- Pain Management Service, Stockport NHS Foundation Trust. Aimed to reduce waiting times for patients living in pain who rely on high doses of opiates.
- Paediatric Department, University College London Hospitals. Sought to reduce non-attendance for appointments at a young people’s rheumatology clinic.
The teams joined a series of workshops with industry professionals, academics and patients to build knowledge, generate ideas, test, and learn from innovative interventions.
Each test team was allocated a volunteer co-researcher with relevant experience. They were selected from applicants to support the test teams on their journey by contributing their unique perspectives and helping them to capture and share their insights.
The approach
The Lab process followed the ‘double diamond’ approach.[ref]Design Council. The Double Diamond. [/ref] This well-established format for design and innovation breaks the process down into four stages.
- Discover. Taking time to understand the problem in detail, rather than making assumptions.
- Define. Using this understanding to define the challenge being faced.
- Develop. A creative process to generate new ideas in response to our clearly defined problem.
- Deliver. Testing and refining new solutions.
There is often a temptation in improvement and innovation to jump to solutions and actions. This can be especially true when there are immediate delivery pressures, as we are seeing in the health and care system right now. But it is also important to know when to slow down.
Explore the outcomes
Through Q Lab, each of the four test teams developed a new understanding of the issues they brought to the process. They identified and navigated barriers to improvement and tested improvement measures in their settings, some of which have had a significant impact on quality of care.
You can read a summary of their project as well as the results and impact in the case studies below.
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Transforming urology pathways to improve care and reduce delays
Case study 18 September 2025 6 minute readA new urology services model successfully improved support for patients by providing care much earlier in the pathway in an enhanced primary care setting. -
Timelier diagnoses for head and neck cancer patients through improved cancer pathway journeys
Case study 14 October 2025 6 minute readPatients were at risk from delays receiving head and neck cancer diagnoses. This project reduced patients’ time to diagnosis from an average of 62 days to 28 days. -
Reducing surgical waiting times for people with complex pain management needs
Case study 8 October 2025 6 minute readThis project reduced clinic waiting times for patients living with complex pain management from 8 months to 23 days, had a 60% average opioid reduction and improved access to elective surgery. -
Pathway to Equity: working with young people to reduce hospital appointment non-attendance
Case study 25 September 2025 6 minute readApplying a systems-thinking approach and co-designing with young people and clinicians, this project reduced outpatient hospital appointment non-attendance by 33% saving an estimated £76,000 p.a.
Contact Q Lab
Contact us about Q Lab at Qlab@thenhsalliance.org
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Mental health problems and persistent back and neck pain
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