2018/19 Outpatients & Planned Care conference review

We held our penultimate national conference of the 2018/19 Network programme on Thursday 28th February 2019. This is the second year the Network have held the Benchmarking & Good Practice in Outpatients & Planned Care conference. This year, the Outpatients project has been delivered in collaboration with the GIRFT Outpatient workstream, to reduce the data burden.

First to the lectern, we heard from John Hadley, GIRFT Lead for Outpatients services. John Hadley described the “enormous focus on Outpatients”, referencing opportunities to develop new roles in the nursing workforce; models of practice to identify what good looks like; as well as highlighting the technological focus in the NHS Long term Plan, whereby a redesign of outpatient services over the next five years will increase the amount of virtual clinics.

We then moved onto the Outpatients and Planned Care findings, delivered by Claire Holditch, Director of the Network, and Sue Ikin, Programme Manager for Outpatients & Planned Care. The focus remained on technology, with data showing that there is a range of Trusts who complete purely electronic records, purely paper-based and those completing a mix of both paper and electronic records for their service. Data provided for virtual clinics demonstrates that this practise is still in its infancy, with video clinics rarely being implemented. The data provides a baseline for video clinics in Outpatient services and it will be interesting to see the trajectory of this in future iterations of the project.

Sherwood Forest Hospitals NHS Foundation Trust presented the first of our good practice sessions. Lynn and Ann shared their personal journey, implementing an Outpatient Improvement Programme to improve service delivery. Three main areas were focused on during the presentation; DNA improvements; attention on the reception team, whereby training and the development of SOPs improved staff retention; and integrated practice in the case note store, where Sherwood Forest have achieved 99% case note availability.

Following a lunch and networking break, we returned to hear the second of our policy updates. NHS England and NHS Digital delivered a joint presentation on the developments of the electronic Referral Service (e-RS). Stephen Firman, Senior Responsible Officer for e-RS at NHS England stated how the service “empowers patients to take charge of their own referrals”. The service has allowed for a rich dataset, due to GP referrals to acute trusts being at an advanced stage. e-RS is currently being piloted in Mental Health trusts. Another point of note from the presentation was how e-RS has supported demand management through capacity alerts, which have shown to have “significant behavioural shifts in referrals”. There is a plan to roll capacity alerts out to 50 trusts within this financial year; with further work expected within the NHS Long Term Plan.

Our second good practice of the day was delivered by The Robert Jones & Agnes Hunt Orthopaedic Hospital. Steph and Liz explained their Improvement Champions Programme, discussing the training and monitoring their journey to date. There was a focus on how data can be used as a method for measuring activity, and how NHSBN outputs have helped towards business cases and implementing good practice.

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We continued on the theme of using data for service improvement, hearing from St George’s NHS Foundation Trust on how their Informatics team have worked alongside the Outpatient Transformation Team to show DNA rates in a clear format, to enable efficient and accurate analysis of their Trust activity. Presenters, Charlie and Mark, champion Tableau and complimented the dynamism of the programme for data analysis.

We heard a different perspective for our final good practice of the conference; Edd and Mel from Sheffield Children’s NHS Foundation Trust spoke about their mission to reduce Was Not Brought (WNB) – the ‘DNA’ for Children’s hospitals. The Trust implemented Paper Switch Off, opened their contact centre until 8pm with no additional investment, and reviewed their clinic utilisation process, all of which impacted positively on WNB rates. They closed their presentation with a campaign video hot off the press: #TakeMyPlaceNHS – an initiative to reduce WNB.

Thank you to all delegates and speakers for their input in the conference and project. Project outputs are available on the members’ area with the summary report being published in March 2019. If you have any Outpatient project queries, please contact Chris McAuley. If you have any Planned Care project queries, please contact Joylin Brockett. The 2019/20 work programme has now been shared with members, and we are looking forward to seeing the developments of Outpatient services in the third year of data collection.