The current waiting list to have Carpal Tunnel Syndrome screening performed within the Department of Clinical Neurophysiology of a large university teaching hospital is 255 days. This delay in access to the service causes increased stress amongst staff and anxiety of patients as they are spending increased amounts of time in the symptomatic state and their condition can also deteriorate while waiting. The aim of this organisational developmental project is to reduce the waiting time to have Carpal Tunnel Syndrome screening performed. The project involved the redesign of the Electromyography service’s process with demand shifted by the addition of waiting list validation and referrals inappropriately referred to this hospital were redirected to the appropriate hospital. The new process involved the introduction of an extra technologist lead clinic to increase throughput along with the application of lean methodologies to remove waste and improve the efficiency of the bottlenecks in the existing clinics. These demand and capacity measures caused a significant (35 %) reduction in the waiting time for Carpal Tunnel Syndrome screening to 166 days, increased efficiency as seen by a reduction in the ‘fail to attend’ rates resulting in cost savings for the organisation but also increased equity of access. This enabled a greater understanding of the service on a micro level with acknowledgement that demand and capacity variation and its management is a vital part of waiting list management along with the appropriate use of the constraint, which is the bottleneck
