Appendix 6.
Self-assessment checklist for NHS boards
The checklist on the next few pages sets out some high-level statements about diagnostic services based on issues raised in this report. NHS boards should assess themselves against each of the statements and consider which statement most accurately reflects their current situation:

Not in place and action needed.
Not in place but action in hand.
In place but needs improving.
In place and working well.
This approach will enable boards to identify what action needs to be taken.

Self-assessment of diagnostic services
The last column in the checklist can be used to record sources of evidence, supplementary comments to support your assessment or to highlight areas of interest, etc.

Issue	Assessment of current position
	Comment to support or explain
your statement	
	No – action needed	No – but action in hand	Yes – in place but needs improving	Yes – in place and working well	Not applicable		
Do you benchmark with endoscopy units across the UK which are returning better GRS scores to identify good practice that can be applied locally?
							
Do you offer patients a choice of date and time for all diagnostic appointments?
							
Do you have local targets for test turnaround times that reflect their clinical urgency?

Do you monitor performance against these targets?  							
Do you pool waiting lists for diagnostic radiology and endoscopy tests across consultants?
							
Do you have diagnostic test protocols and referral guidelines in place for GPs and clinicians?

Are GPs and clinicians using these?							
Do endoscopy and radiology departments have processes in place to check referrals for diagnostic tests to ensure they are appropriate? 
							
Do you collect and monitor information on the source and level of demand for diagnostic tests, and feed referral rates back to GPs and clinicians?

Issue
	Assessment of current position
	Comment to support or explain
your statement
	
	No – action needed
	No – but action in hand
	Yes – in place but needs improving
	Yes – in place and working well
	Not applicable
		
Have you explored the possibility of extending the range of diagnostic tests that GPs can refer patients for directly through clear protocols?
							
Are diagnostic services included in the board’s planning for achieving and maintaining the new 18-week referral to treatment target?
							
Do you collect and monitor local information on the performance of diagnostic services?
For example:

•	number of planned sessions that were used
•	test turnaround times. 							
Do data reported to the Cost Book reflect data that are reported to the Keele Benchmarking Scheme and the NHSScotland Radiology Benchmarking Project?
							
Do you review performance of diagnostic services against indicators of efficiency and make use of benchmarking data to identify potential improvements on an ongoing basis?
							
Are there guidelines in place for clinicians and GPs to help reduce 
repeat testing?