Information Requirements

Information Requirements from August 2020 (July 2020 data) onwards

Definitions: General

 

Term

Definition

See on Symptom (SOS)

A ‘see on symptom’ approach results in patients being discharged to an SOS pathway as an outcome of their last review by a clinician when it is clinically safe to do so, and then relies on the patient to self-refer if there are any issues with their condition.

 

See on symptom pathways should be utilised for short term conditions.

 

Where it is safe to do so, patients are discharged to an SOS time defined pathway and the patient record is updated accordingly. At the time of the decision to place the patient on to an SOS outcome, the clinician should determine and clearly communicate to patient, the timeframe for SOS access. Once the agreed period has passed the SOS pathway is automatically closed and no further action is required.

Patient initiated follow up (PIFU)

 

A Patient initiated follow up could be utilised for long term/chronic health complaints e.g. rheumatology linked conditions. A patient may be discharged to a PIFU pathway as an outcome of their last review by a clinician.

A PIFU pathway can be used for cases where the next appointment does not need to be booked at that point in time as the condition is being managed well by the patient.  Therefore, the patient and clinician agree that the Patient initiates the next Follow UP when required.   The clinician may still need to review the patient (with or without the patient) at a defined time in the future in order to ensure NICE guidelines are followed and that patient care plans are still appropriate. Patients who have been discharged to a PIFU pathway and have not contacted the hospital regarding their condition for 2 years will be clinically reviewed by the clinician (office-based decision and/or use of PROMs) and a clinical decision made regarding future management of the patient’s pathway.

By Treatment Function

 

1.  Total Number of Patients Waiting for Follow-up where there is NO Documented Target Date

1a) This is the total number of patients who;

 

i.    are waiting for a follow-up appointment but there is NO documented date for when that follow-up appointment should take place (Target Date)

 

ii.   do not have a documented date for when the follow-up appointment should take place and it is unclear whether  or not they require or are waiting for a follow-up

 

1b) Total number of patients where the outcome of their last review by a clinician was ‘discharge to SOS pathway’.

This cohort of patients will not appear on the Follow Up Waiting List but instead be included in the SOS pathway list for the clinically determined time period (maximum 12 months). After this time, the patient will be automatically removed from the SOS pathway list.

 

1c) Total number of patients where the outcome of their last review by a clinician was ‘discharge to PIFU pathway’.

This cohort of patients will not appear on the Follow Up Waiting List but instead be included in the PIFU pathway list. If a patient does not re-engage with services after a period of 2 years, this will be flagged up for validation and virtual review by a clinician.

 

 

2.  Total Number of Patients Waiting for Follow-up where there IS a Documented Target Date

 

2a. Number of Patients Waiting for Follow-up where there IS a documented Target Date (Not Booked)

This is the total number of patients who are waiting for a follow-up where there IS a documented date that the follow-up appointment should take place. This ONLY relates to those patients with a target date that HAVE NOT been given an actual 'booked' date to come back for their follow up.

 

2b. Number of Patients Waiting for Follow-up where there IS a documented Target Date (Booked)

This is the number of patients who are waiting for a follow-up where there IS a documented date that the follow-up should take place AND who have been given an actual date for their follow-up appointment, also referred to as ‘booked’ patients.

 

3a & 3b The Number of Patients Waiting for a Follow-up who are Delayed past their Target Date

 

This is the number of patients who are waiting for a follow-up over their target date split by how long they are delayed - the delay is calculated as a percentage. The calculation of the delay only relates to those patients WITH a documented target date and is reported separately for ‘Booked’ and ‘Non Booked’ patients (2a and 2b).

 

For each patient pathway, the method for calculating the % delay beyond the target date can be described as follows:

 

If:                

Census Date = A

Target Date = B

Original Outpatient Attendance Date = C

 

Then:

           

 

 

For example:

 

Outpatient Attendance 1st November 2014

Target Date: 1st December 2014

Census Date: 15th December 2014

 

 

               

 

 

 

Note: No deductions should be made to the percentage reported based on any other existing guidance.

 

 

3c. Number of patients waiting for a follow-up who are delayed past their target date BUT Could Not Attend (CNA) or Did Not Attend (DNA) their last appointment.

 

Of the total number of patients delayed past their target review date (3a +3b) how many previously CNA or DNA their last appointment.

 

These patients can either be booked or un-booked at the time of reporting.

 

The purpose is to quantify of the number of patients delayed past their target date (Counts 3a + 3b) how many had DNA’d or CNA’s their last appointment.

 

 

 

Supporting Definitions

Target Date 

 

The target date as defined in A Guide to Good Practice (2005), is the date that a follow-up appointment SHOULD take place. 

 

A Target Date should only be changed where it is clinically relevant and should never change as a result of a DNA or CNA without clinical review.

 

Follow-up attendance

A follow-up attendance is initiated by the consultant or independent nurse in charge of the clinic under the following conditions:

a)

Following an emergency inpatient hospital spell under the care of the consultant or independent nurse in charge of the clinic.

b)

Following a non-emergency inpatient hospital spell (elective or maternity) under the care of the consultant or independent nurse in charge of the clinic.

c)

Following an A/E attendance to an A/E clinic for the continuation of treatment.

d)

An earlier attendance at a clinic run by the same consultant or independent nurse in any Local Health Board/Trust, community or GP surgery.

e)

Following return of the patient within the timescale agreed by the consultant or independent nurse in charge of the clinic for the same condition or effects resulting from same condition.

 

 

Outpatient Follow-up Delay Pro Forma Data Collection Tool