Patient Focused Booking Raigmore Hospital Radiology Katherine Sutton NHS Highland Superintendent Radiographer

January 2006 Bookings undertaken by a variety of staff Radiographers – all Grades Radiography Helpers Receptionists Secretarial staff In a variety of locations

Long Waiting Lists – up to 42 weeks Disgruntled & Overworked staff No understanding of the capacity of the booking system No understanding or control over utilisation of clinical capacity A complete lack of understanding of demand on the clinical service

April 2006 Diagnostics Collaborative Programme was launched Promise of additional resources! Tools and techniques for Demand, Activity and Capacity measurement A real interest in Radiology and its internal workings!

Where were we then? DNA Rates of up to 15% in the modalities that were to become target focussed No clear systems for measuring and monitoring capacity Issues with taking in turn A complete lack of understanding leading to a lack of control over our systems

What did we do? Agreed to implement patient focussed booking Agreed to offer patient a choice by telephone Agreed to implement a fast track pathway Agreed to take in turn wherever possible

Implementing Patient Focussed Booking Instigated an Organisational Change Programme Focused on separating reception from Bookings Included public members involvement Agreed that bookings would be made via one contact centre for all modalities

Keys to success Booking Guidelines for all modalities Training plans for booking staff Templates set and agreed for all modalities Weekly meetings including all key stakeholders Highly motivated team Prioritising the tail of the waiting list Filling all cancelled slots

Measures of Success !! Waiting Times have fallen from 42 weeks to 2 weeks!! Two week position is sustainable!! DNA Rates have fallen from 15% to 2%!! CNA Rates – generally around 2% Positive feedback from patients and clinicians Patient complaints are rare – non –existent Motivated and confident staff Patient focussed booking is being implemented for all Highland Radiology Departments via a centralised model

Where now? Challenged with rolling the Radiology model of booking across all other specialities Successful trial for ENT – reduced waits and DNAs significantly and improved list utilisation Implemented for Orthopaedics and Endoscopy Now full implementation for remaining specialities is being requested including Non-Medical services and AHPs

Refining of the Radiology System External expert review Developed an appropriate management structure Team Managers and Quality Coaches Introduced governance and procedural processes into Bookings Vision of one contact number for patients to book any appointment

Further refinements Review of all patient correspondence Set up a formal patient contact group including equality and diversity representation Patient Access Policy Implemented Formal training programme for all booking staff Business rules for booking agreed with and signed off by clinicians Key Performance Indicators are being developed to measure the outputs of the booking service

NHS Highland Patient Booking Service Supporting Environment

NHS Highland Patient Booking Service Patient Booking Processes

2010 Leading to a full Admin review across Highland Has focussed minds on a whole system approach Leading to full understanding of demand and capacity Further improving Radiology utilisation and organisation

Further information: Katherine Sutton Superintendent Radiographer Maimie Thompson 18 Weeks RTT Programme Manager