National Demand Optimisation Group (Ndog) – Phase 3 Report

The National Demand Optimisation Group (NDOG) is a Scottish Government commissioned group. Its main objective is to reduce unwarranted variation in laboratory diagnostic testing, contributing to improved patient outcomes The group has recently completed its third phase of work.

1 Foreword

The Scottish National Demand Optimisation Group (NDOG) continues to produce invaluable reports and recommendations which highlight proactive measures to reduce unwarranted variation in the delivery of healthcare. Laboratory testing continues to be a fundamental aspect of healthcare, and existing unwarranted variation and inappropriate diagnostic test requesting still exists in all NHS Boards in Scotland. In line with the ethos of Realistic Medicine, the NDOG have continued to work with colleagues across the wider healthcare community and in Scottish Government to address this unwarranted variation and contribute towards improved outcomes in patient care.

This report highlights the outcomes of the Phase III programme of work, including the refinement of the Atlas of Variation, extensive data collection work and wide-ranging Quality Improvement activity to address the unwarranted variation in laboratory diagnostic testing. Building on the momentum of Phase II work, it is particularly important to note the successful engagement and meaningful dialogue with the primary care community to inform improvement work.

The appropriate and targeted use of diagnostic testing and efficient use of scarce resources will be integral to the realisation of improved and optimised patient outcomes in NHS Scotland in the post-COVID-19 healthcare landscape. We fully endorse the work undertaken by the Scottish National Demand Optimisation Group to lead the drive towards appropriate test use and support ongoing engagement with the wider healthcare community, including close collaboration with laboratory and primary care colleagues. Given the impact that the COVID-19 pandemic has had on laboratory testing workflow, it is important that future Demand Optimisation work focuses on measuring such impact both during the pandemic and recovery phases – such valuable data can then be shared with remobilisation teams within the boards, but also Primary Care leads/strategists. I look forward to seeing the outcomes delivered as part of the Phase IV programme in the year ahead.

Catherine Ross

Chief Healthcare Science Officer

Scottish Government

Dr Gregor Smith

Interim Chief Medical Officer

Scottish Government



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