1. 'Demand and Capacity Management - Choice Appointments' An Innovative and Patient-Centred Quality Appointment System Dr Robert Jones Head of Therapy Services Directorate East Sussex Hospitals NHS Trust Purpose To improve patient access, reduce “did not attends” (wasted appointments), reduce waiting times and improve patient satisfaction, providing more clinically effective interventions as patients no longer have to wait for treatment. To restructure use of staff time, basing the system on capacity planning. Relevance System in operation 6 years in Eastbourne and 4+ years in Torquay Designed to make more effective use of physiotherapy time and improve patient experience Description Designed and developed by Eastbourne Physiotherapy service, East Sussex, “Choice Appointments” is a system of Physiotherapy same day out-patient appointments given by phone for musculoskeletal conditions for new referrals and follow up appointments, achieved within existing resources. The process includes: Department demand and capacity calculation Patient referral to the service Patient telephones to book an appointment on the day they wish to attend Minimum pre-booking Patients agree goals to achieve before accessing further intervention Follow-up appointments managed in the same way Outcomes The change has been sustainable for 6 years and has been replicated in 18 other Trusts to date No increase in staffing or costs Improves access and clinical service provision Improved patient satisfaction and excellent clinical outcomes No waiting times or “DNAs”, challenges existing work practices, empowering patients to choose when they come for treatment Suitable for services wanting to reduce referral to treatment time The system is transferable to other locations, services and countries The process re-design uncovers extra capacity at no extra cost Reference and Contact Details Jones R, Jenkins F 2007 – “Key Topics in Healthcare Management – Understanding the Big Picture” – Allied Health Professions – Essential Guides. Radcliffe Publishing Limited, Oxford Contact: RF@jjconsulting.org.uk Fiona Jenkins Formerly Clinical Director of Therapy Services South Devon Healthcare NHS Foundation Trust Produced by the Medical Illustration Department at Eastbourne District General Hospital Evaluation “Did not attends” and waiting times minimised to < 2% in Eastbourne and Torquay.“Did not attends” and waiting times minimised to < 2% in Eastbourne and Torquay. Formal audits on patient experience indicating 94% of patients were able to book an appointment convenient to themFormal audits on patient experience indicating 94% of patients were able to book an appointment convenient to them Complaints about waiting times eliminatedComplaints about waiting times eliminated Reduced time per patient episode - leading to greater capacityReduced time per patient episode - leading to greater capacity Fig 1 - % “Did Not Attends”Fig 2 - Routine Waiting time (weeks)Fig 3 - Waiting time ComplaintsFig 4 Minutes per treatment episode