Use of standardised pathway times to improve timely care in ILD and what waiting times are acceptable to ILD patients

<bold>Introduction and Aims:</bold> Delays in Interstitial Lung Disease (ILD) diagnosis and treatment have been linked to reduced lung function, duration of antifibrotic treatment, and time to death (Christopher J.B et al. ERJ 2020). Standardised pathways with clear timings are used in other specialities to improve care and reduce delays. We aimed to 1) Review the literature surrounding pathways and timings 2) Survey patients to identify acceptable timings. <bold>Methods:</bold> Medline and Embase search performed with terms: Interstitial Lung Disease* AND ("referral pathway*" OR "diagnostic pathway*" OR "patient pathway*" OR "clinical pathway*") correlated with IPF, PFILD, delay, or waiting times and similar terms used in Google. Digital surveys sent to 200 patients in the ILD support group, 64 responded and results analysed in Excel. <bold>Results:</bold> Pathways can be beneficial by reducing complications, cost, and length of stay. Targets like the 2 week-wait in Oncology can reduce delay (Neal, R.D et al. BJC 2014). No standardised pathway identified in ILD. Referral to clinic times ranged from 15 business days to 90 days. Patients reported <1 month (51.6%) or 1-3 months (45.3%) from referral to clinic and <1 month (50%) or 1-3 months (27.4%) from clinic to treatment was acceptable. Patients on average wait 13.6 weeks to first clinic in the UK. <bold>Conclusions:</bold> Patients and clinicians can benefit from pathways and targets, and they can reduce delay. Surveyed timings in line with UK and international targets but waiting times are above these due to increased service demands. Standardised pathways may support ILD service resource planning and in securing homogenous care.