Scottish Access Collaborative

For NHS, Scottish Government

Scottish Access Collaborative brings together clinicians, management, third sector, government, and patients from across Scotland's healthboards in a series of design-led workshops. The aim was to map the current landscape, challenge assumptions, share good practice, capture areas of opportunity, generate ideas, and identify meaningful change.

I led on designing and iterating the methodology and tools for these workshops, and on developing system visualisations. The focus was on applying an end-to-end system approach, and to identify cross-cutting solutions in order to reduce waiting times.

Symptom Profiles and Pathways

At the start of the process, every specialty group works together to agree on the most common or most troublesome symptoms presenting to their services. The aim is to develop a shared high level understanding of the current state of care by visualising some of the common examples of existing pathways, by comparing variation across Scotland and noting local innovations, and by exploring the people, places, equipment, and actions involved in each symptom pathway.

Key Issues

This discussion then helps to identify a set of key issues the specialty group would like to work on in the following weeks. Using visual tools, the group illustrates and locates key issues within existing symptom pathways, and considers issues from different perspectives such as GP, patient, consultant, manager, physiotherapist, or dietician. Many of the issues highlighted stand out as being challenges for more than one symptom and from more than one perspective, and these cross-cutting themes are key areas for improvement and could deliver significant impact for patients and staff.


Next, each specialty group translates these key issues into a number of challenges starting with "how might we...?". After prioritising and selecting these challenges, people form small groups and start considering the improvements which could respond to their chosen challenge.

Ideas and Recommendations

The outcome is a series of agreed recommendations and ideas for service improvements most likely to make a difference to patients and staff. They are detailed in each specialty report which will now be taken forward with national support through the Scottish Government's Combined Action Group.

What people said about this project: