Improving Patient Experience “Manage Your Referral” website by NHS e-Referral Service Improving Patient Safety & Care 2019 Conference Radhika Rangaraju, NHS England Dr Michelle Durham, NHS Digital 6th February 2019

NHS e-Referral Service National Asset Professional Application Integration Referrals Advice and Guidance Capacity and Demand Patient Application The NHS e-Referral Service is an electronic enhanced referral service. National asset in place and available at no cost to NHS organisations Stable technology, low incidents rates The professional application Enables referrer clinicians to electronically refer patients, giving patients a choice of providers, and provider clinicians to electronically review referrals Enables two way Advice and Guidance dialogue between clinicians to optimise patients’ care Helps provider organisations with capacity and demand planning The patient application Provides patients with a choice of place, date and time to book their own appointment for first outpatient attendance around their other commitments

The Patient’s Journey Patient Patient G.P. Appointment cancelled Patient asked to rebook Further care is needed Reminder sent by e-RS Patient Patient Patient Attends appointment National call centre (TAL) Tablet/ phone/ PC GP opens e-RS and selects a short list of appropriate services with the patient The GP gives the patient the booking instructions The patient selects the place, date & time Books Appointment So how does this all work? Explain the current referral and booking process....slowly...using the mouse clicks to build the picture G.P.

Our driver Improve patient experience Everyone accepted we needed a new patient booking website   We all knew the previous website was difficult for patients to use and did not work well on phones or tablets but we just weren’t getting it right. We started looking at other health booking websites and questioning the universal truths about our patient website.

How we built “Manage Your Referral” No empty slots = positive perception of service We went back to the drawing board We spoke to patients. Lots of patients. In homes, at outpatient wards, in libraries with people with poor literacy skills, listening in to bookings calls at the National Telephone Appointment Line and conducting online surveys to understand there needs and frustrations with booking online. We developed a Happy Path to build against Login Landing Page Select Clinic Select from a list of available appointments Review Confirm HAPPY PATH CHOICE CHALLENGE

What we learnt Iterations Piecing Data Together Universal Truths User Preferences Iterations Piecing Data Together Universal Truths Initially we tested the existing prototype. In this clinic selection screen, early designs had patients adding services to a shortlist, before choosing where to book This design was tested at an adult community learning centre in an area of economic deprivation, participants found the screens were still too complex both on desktop and mobile.

Our Offer – Empowering Patients Easy to use screens Safe and secure process Accessibility information compliant Colour coding to make patients aware of where they will get treated the quickest Links to NHS UK (previously NHS Choices) to compare the selected clinics Ease of selecting an appointment that suits the patient’s needs. We developed a simple, clean looking set of screens that were easy to use, helping patients manage their own booking around their other health and everyday life needs.

Our Offer – Empowering Patients The ability to change or cancel an appointment without contacting any healthcare professional Coming within the next 6 months: Ability to manage multiple referrals in one place Paperless login using your NHS Login details Patient satisfaction is high with MYR and we are continuing to develop more functionality to further enable patients to manage their bookings.

How are we doing? Jan 2017 MYR launched – feedback is gathered to inform regular improvements of the website Aug 2018 GP comms sent out to encourage use of MYR to empower patients to manage their own care The graph shows that percentages of MYR are rising against telephone bookings. Use of e-RS, however, is also rising and absolute numbers of bookings through MYR have nearly doubled over the last 2 years Analytics show High completion rates for patients who start the booking process in MYR High satisfaction rates with the MYR website MYR delivers cost savings through reduced admin time spent managing appointments and 50% reduction in DNA rates when patients select their own appointment Figures have been rising but could be much higher. GP admin and hospital admin are still booking the majority of appointments. Our message today is: Empower your patients and let them book their own appointments Realise the savings by letting patients book using MYR

Clinicians – Empower your Patients Patients – Manage your Referral Looking to the future Clinicians – Empower your Patients Patients – Manage your Referral Save time

Questions Radhika Rangaraju National Programme Lead, NHS England radhika.rangaraju@nhs.net Twitter - @radmad11 Dr Michelle Durham Clinical Lead and Clinical Safety Officer, NHS Digital michelle.durham1@nhs.net