by Dr Mark Bailey

Poster Download

Background & Problem:

Undertaken in the Respiratory and lung function department. Involved doctors, secretaries, physiologists and obstructive sleep apnoea hypopnoea syndrome (OSAHS) patients. The main aim of the service improvement was to improve the high number of waiting time breaches. Baseline data was waiting times for sleep studies, starting continuous positive airway pressure (CPAP) and clinic appointments.

Undertook library evidence search.


Reduce waiting time breaches by 80% over a 1-2 year period for sleep studies, clinic appointments and CPAP.


Regular meetings with senior Dr White, secretary (then Kim Edge) and the lead physiologist Beverley Gray to discuss and implement changes to the service. The changes made to the service were multifold. We measured time of each part of the pathway.


Comparing waiting times from September 2017 to February 20108 with September 2019 to Feb 2020 we saw a drop in waiting time breaches of 81% for sleep studies, 79% for starting CPAP and 90% for clinic appointments.

Lessons Learnt:

Patient and good communication skills are important to get key players on board with and then involved in making service improvements. Learning points for others include training of non-clinicians to run clinics and analyse investigations and the use of a database with automation to create a secure platform for patient data and to speed up processes.

Next steps:

Potentially we will move towards the use of electronic tablets to collect patient sleep questionnaires. We are also looking into created personalised educational videos to replace the need for sleep clinics.

Quality Improvement Presenter
Dr Mark Bailey, Speciality doctor in Respiratory Medicine
Quality Improvement Team
Beverley Gray (lead physiologist)
Kim Edge (Assistant General Manager in Cardiology and Respiratory Medicine)
Dr Andrew White (consultant)
Judit Nemeth (sleep coordinator)
Joseph Mills (GM)
Dr Henry Steer (respiratory clinical lead)