Outpatient waiting lists for the early winter months have fallen for the first time in three years. This is despite an annual first attendances rise of 2.2% to 11.8 million.This speeding up of the outpatient system is the first sign that the hard hitting report of the Treasury’s Public Services Productivity Panel published last year has diagnosed the problems and prescribed practical solutions. The Review Team found archaic systems, many dating back to the 1950s. They also found wide variations in outpatient performance across the NHS. This was the first time there had been a major emphasis on reducing outpatient waiting lists.
Lack of leadership was a major issue and NHS Trusts are now appointing a Director with responsibility for management of both in and outpatient waiting lists. The leadership failure led to an absence of information to manage the outpatient system. Much of the data needed was collected for contract management and to compile waiting list statistics, but it was not used for managing the process. Trusts are now introducing a Clinic Management System which will allow them, for example, to identify spare capacity.
The Review Team also found that a fundamental weakness in the majority of outpatients systems was failed appointments which average 25%. The failure of an appointment can result from hospital cancellation or outpatients failing to attend. The underlying cause of failure is the inflexible booking system which specifies an appointment months in advance and takes no account of changed circumstances. Trusts are now introducing partial booking systems where the date is firmed up with the patient four weeks before the appointment. This can reduce waiting times by 40%.