This initiative sought to reduce the waiting list and to improve the triaging process of an out-patient multidisciplinary team based at the Royal Hospital for Sick Children in Edinburgh. The team consists of 6.5 whole-time equivalent clinicians and receives 250 referrals of children aged under 14 each year. All referrals (n=66) on the waiting list were offered an initial assessment during a 2-week period in July 2005. Interdisciplinary pairs were formed and each pair was assigned a clinic session comprising two 1-h assessments. A weekly meeting was held to discuss all cases and to prioritise and allocate according to need and the skills required to manage the problems.

Sixty-six patients were offered appointments and 46 of these attended. Thirty-seven patients (56%) were allocated to clinicians for further management, 21 (32%) cases were closed and 8 patients (12%) remained on the waiting list for further management. After 6 months, there were 33 on the waiting list, with an average waiting time of 5 weeks, which was down from 4.5 months.

The initiative was an effective way of assessing and allocating patients in a more appropriate and timely fashion, and resulted in a considerable improvement in the service offered. It also resulted in the establishment of regular ‘initial assessment clinics’. The experience had the effect of motivating the team, encouraging the sharing of ideas and generating action.