Introduction
Demand Optimisation Test Case Library
On establishment, the National Demand Optimisation Group (DOG) undertook a diagnostic exercise with
the aim of identifying relevant pieces of work at a local level across Scotland addressing identified needs
for demand optimisation. Where the diagnostic exercise identified innovation, greater detail was sought to
allow the development of a library of Demand Optimisation test cases.
The aim of such work was to allow cross‐fertilisation of knowledge in this area and to act as a catalyst for
change for a variety of clinical and management teams working within the NHS as well as those working
within Health and Social Care. Ultimately it was hoped that such work would highlight the principles to
address identified waste or variation.
Examples of work include:
• Collaborative working between laboratory services, Sexual Health and Primary Care to optimise the
diagnosis of female genital infection
• Optimisation of the use of urinary culture in asymptomatic patients to ensure that it was not used
where results were unlikely to alter clinical management.
• Evidence based alteration to the protocol for serological testing for rheumatoid arthritis.
• The use of a dashboard tool within Primary Care to provide feedback on the use of diagnostic tests
and optimise their appropriate use within this setting.
• A review of the clinical appropriateness of the need to refer samples for the assessment of markers
CA19‐9 and CA153 to laboratories outside local lab
• Reviewing the constituents of Liver Function Test Panel.