Greater Manchester Electronic Booking Programme

Booking- what are we working towards? NHS Plan Booking Targets combined with major service redesign Patient must have a choice of date, time and location Choices must be clinically relevant Patient must be able to exercise their choice within 24 hours of the decision to refer If there is a long wait for a service the patient must be informed of the indicative wait time at the point of referral Patient opt in Choice at point of referral – Dec 2005

Greater Manchester Approach Led by the Strategic Health Authority PCT owned GMEB team Greater Manchester Programme Board Local Healthcare Partnerships Steering Groups and Teams Monthly stakeholder events Part of Whole systems change to improve access

Enterprise Community Aims Implement the Transaction Broker using people Redesign processes in preparation for booking Ensure communication re: Booking Targets widely established Establish Referral & Booking Management Service Equality of access by involving all GPs Link to rest of local modernisation agenda e.g intermediate services (Tier 2) & capacity/demand Develop a Directory of Services which will include waiting times information, availability of services and criteria to book

Greater Manchester Approach Establish technically linked PCT owned contact centres across Greater Manchester creating a virtual Greater Manchester BMS. Capture all GP referrals in existing formats Accumulate referral information to inform commissioning and development of intermediate services (Tier 2) Give patients a single point of contact for all queries Exam the affects of patient choice Exam impact at all organisations involved in booking

All GP OP referrals Within PCT PCT Referral and Booking Management Service RMBS Centre Acute Trust A Patient Admin system Acute Trust B Patient Admin system Acute Trust C Patient Admin system Tier 2 service Greater Manchester Patient Directory of Services

Greater Manchester PCT RBMS Capture & Convert Conversion to Outpatient registration on hospital Patient Administration System Booking Primary Care Request Book OP appt PCT BasedAcute Trust

Greater Manchester PCT RBMS Capture & convert to electronic document Tier 2 Discussion & Direction ConversionBooking Primary Care Request OP Referral, Diagnostic request, back to GP Book OP appt or diagnostic test PCT Based

Patient Choice/Directory of Services Greater Manchester Directory of Services Initially made be made up of local DoS for each RBMS Local DoS would contain information on bookable services relevant to a specific RBMS depending on Acute Trust PAS access. Develop minimum information to book per clinic e.g appropriate for OP procedure etc Exclusions Ensure referrals include minimum information to book Consultant working from multiple hospitals Open referrals

Consultants view All referrals are registered by the RBMS centre. The expansion of Tier 2 will accommodate patients who dont require secondary care Possible change in referral patterns – GPs dont need to refer to specific consultant just to be able to track the referral Agreed appointments will be booked by the RBMS centre with the patient Reduce DNAs and patient cancellation

Consultants view Soon able to view captured referrals in electronic format Working towards the ablility to prioritise and accept referrals on-line Indicate next steps – i.e. scan before appt and track the steps to allow the RBMS centre to be able to inform the patient Help develop Greater Manchester Directory of Services Reduced secretarial time chasing information for patients – the patient will contact the RBMS centre RBMS centre able to produce copy of original referral if required – all scanned on receipt

Patients view Improved Access, Booking and Choice Single point of contact for queries and cancellations Able to have choice in the appointment date, time and location for specialities/services subject to roll out plan Reduced anxiety – fully informed of booking processes Able to access information on available services and waiting times Looking at developing processes to allow on-line booking for authorised booker – chronic disease

GP Practice View Single point of referral for each PCT Confirmation of receipt of all referrals by the centre – no more chasing Ability to view status of referral on line or by contacting centre Patient queries directed to the centre Issue Patient Information Leaflet & card to all patients being referred In near future centre will link appt to PTS if indicated by GP – pilot starting in 2 months

GP practice view No major change in current practice – just send referral to single point. Will be able to refer electronically but not required to Electronic referral can be generated by practice staff and then authorised by GP Will need to work towards standardised referral content. LHPs to manage this process. Patient posters Free postage envelopes GP information pack Leaflets in all formats

Implementation Programme for 21st Century ICT Components – ICRS – E-booking – E prescribing – Infrastructure Greater Manchester structure links Modernisation and NPfIT GMEB redesigning processes and procedures in preparation for Electronic Booking Services

Communications Media Patients and public involvement Local ownership versus standardisation – Leaflets, opening hours, exclusions RNID/RNIB/Non-English Telephone messages Video Newsletters/Flyers etc Managing expectations

Progress to date All 11 RBMS centres plus 1 tertiary centre open since May 2003 (full Greater Manchester coverage) Over 250,000 referrals received 70 – 80% of all calls answered in 30 seconds Management reports available Directory of Services – commenced collection of information for all outpatient clinics across Greater Manchester RBMS Centre procedure guide, includes standards

Next steps…. Emphasise PCT ownership performance standards and sufficient resource Trajectory Plans Agree Booking Baseline Agree Definitions Maintain/expand partial booking in outpatients OP Booking for services with waiting times 6 wks or less move to RBMS Partial book to pre-assessment More Day Case Booking Booking will be Performance Managed by SHA

Lesson Learnt Service growing exponentially – resources need to be flexible both in numbers and times of day and week. Number of referrals via RBMS growing Number of calls growing but calls dont yet reach referral levels Empowered PCTs – access to information – want more! Constantly reviewing resource requirements – streamlining procedures, improving technology Customer Service Staff development opportunities - NVQ

Contact details Programme Manager Hadrian Communications Manager Admin Manager Website – nww.gmeb.nhs.uk