1. 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

2. 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

3. 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.

4. 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.

5. 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

6. 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.

7. 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.

8. 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.

9. 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

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

11. Questions Radhika Rangaraju National Programme Lead, NHS England
Twitter
Dr Michelle Durham
Clinical Lead and Clinical Safety Officer, NHS Digital