NHS Yorkshire and the Humber commissioned the Improvement Foundation to deliver a programme to support teams from across the SHA area in their work to deliver the 18-week target.

The programme:
• Supported teams to develop a shared understanding of the 18-week challenge and shared resources to support the delivery of the target
• Provided teams with a framework and tools to take forward improvement work for the 18-week target
• Facilitated learning across the teams and supported the development of a community of practice.

Sheffield Teaching Hospitals NHS Foundation Trust chose to work on its respiratory medicine service.

The first step was to work towards providing respiratory physiology tests on demand, so that results were reviewed and early treatment could begin. It also reduced follow up which reduced ambulance use and improved patient experience.

At each site, the systems for carrying out respiratory function tests were reviewed. Where possible procedures were unified and cross-city reporting was introduced to support improved cross-city working. This was the start of developing cross-city clinical pathways, fundamental to achieving the 18-week target.

The diagnostic elements of the cross-city Sleep Service were improved to better meet the needs of referrers and patients.

The results were: a backlog in reporting is now being managed through the introduction of a new appointment system; an additional room for has been identified for performing diagnostics for the Sleep Service; cross-city meetings have been set up to begin work to simplify and harmonise protocols.