NHS Information Environment Policy 01 Patient Choice Linda Blenkinsopp October 2008

Format of the session Recap on Key Reforms Choice - Principles and Benefits Book - Principles and Benefits Patient Rights The Targets The Incentives Group work – “Kramer vs Kramer” The Benefits Implementation Issues Commissioning Issues Recap/Next Session

Key Reforms

Choice – Key Principles What is it ? What Choice have patients got? Why bother? Pulling these together - a working definition

Choice Defined “Choice is the patients right to determine how, where and when they will be seen in hospital. Patients can choose between 4/5 providers (one of which must be the Independent Sector). It will enable the NHS to deliver a more patient- centred service, a better experience for the patient and better care.”

Book – Key Principles What is it ? Who does it? Why bother? Pulling these together - a working definition

Book - Defined Book is the electronic process by which GPs arrange the hospital appointment for the patient in the hospital of their choice. Booking reduces time, costs and DNAs and is more convenient and empowering for patients.

Patient Rights Patients can now expect: To be offered a choice of 4-5 PCT commissioned hospitals or suitable alternative providers Have the availability of “Extended Choice” of any Foundation Trust (now ANY NHS Trust) To be able to book their appointment with their preferred provider Information to be available locally to inform their choice To be supported in making their choice by their GP and, Aftercare/rehabilitation provided locally following any hospital treatment.

The Targets PCTs to commission at least 4/5 providers (1 Independent Sector) All GPs to offer Choice – at least 60% of patients via the Patient Survey 50% of referrals (converted UBRNs) made through the ‘Choose and Book’ system by the end of September % of referrals (converted UBRNs) made through the ‘Choose and Book’ system by the end of February 2007

The Incentives Secondary Care have received considerable funding to support Booking NPfIT provide systems Direct Enhanced Service Payments in 4 parts: –Choice Aspirational payment 0.24p –Choice Delivered 0.24p –Booking Aspirational 0.24p –Booking Delivered 0.24p Note Aspirational payments can be rescinded if the practice does not meet agreed targets.

The Great Debate “Choose and Book – For and Against” 2 Groups – “Kramer vs Kramer” 1 Jury 5 Arguments Feedback and Challenge Decision of the Jury

Choose and Book - Benefits NHS CentredPatient Centred Reduction in administration time at the GP practice to make the referral Reduction in the administration time at the GP practice to make a referral Reduction in administration and clinical time at the Trust to process the referral Reduction in inappropriate outpatients appointments Reduction in practice and Trust staff time to follow up appointment queries Choice of date, time and place for appointment Reduction in postage and stationery costsFacility to change and rearrange appointment dates Reduction in GP appointments by patients awaiting news of outpatient appointments Greater confidence in the hospital appointment process Reduction in Did not Attends (D.N.A s) Improved data quality of referrals i.e. accuracy and completeness, patient demographics and clinical assessment data Improved convenience Reduction in inappropriate outpatient appointments due to improved referral information Reduction in average time from referral to appointment Reduction in the rate of misdirected referrals Improved management information ensuring future demand and capacity of services are matched

Implementation Issues ? Change Management Project Management IM&T Issues Culture Issues Partnership Working Clinical Engagement Training Public Engagement

Commissioning Issues 4/5 providers Predicting Demand Waiting Times Performance Management Referral Management Dynamic Commissioning

Recap/Next Week Choose Book Further Research – Linking to Performance TCT For next week 1 – Informing Choice - What information would you need to support your Choice decision For next week 2 – know your AHC Score