Demand Optimisation is defined as the process by which diagnostic test use is optimised to maximise appropriate testing, which in turn optimises clinical care and drives more efficient use of NHS resource.

Under the auspices of the Healthcare Science National Delivery Plan (NDP), the Scottish Government funded the establishment of a National Demand Optimisation Group (NDOG) to review the third deliverable of the NDP, which states:

NHS Board Healthcare Science Leads will work with stakeholders to develop local improvement plans to reduce unnecessary testing across primary and secondary care. This will free up capacity to address rising demand and deliver testing that positively affects the patient pathway, supports primary care preventative measures and reduces hospital referrals and admissions.

The NDOG is a multi-disciplinary group comprised of individuals from the main diagnostic disciplines within Laboratory Services, the Scottish Government, NHS National Services Scotland (NSS) and the National Managed Diagnostic Networks (NMDNs).

There is considerable variation in the use of diagnostic tests across primary care.  Some of this variation can be attributed to clinical and demographic differences.  However, some variation can be attributable to differences in practice processes and pathways or individual requester approaches or preferences. 

The Atlas of Variation contains monthly data on NHS board primary care requesting totals for a specific suite of blood science tests from cancer, cardiac, diabetes and other general pathways.The Atlas consists of three separate dashboards that allow GP practices to compare their request rates with their cluster, health board, national totals and peer group.

Here is a direct link to the Atlas - Phase5 Primary Care Dashboard | Tableau Public

The Right Decision platform will host educational guidance on key diagnostic tests held within the Atlas of Variation.Information includes: background, when to test, when not to test, when to repeat a test and any further reading recommendations.There is also an opportunity for users to test their knowledge.

If you have any further questions or would like more information, you can get in touch with the NDOG team via nss.nationaldemand@nhs.scot

You can also visit the website - National Demand Optimisation Group (scot.nhs.uk)