Term

Definition

Scope

•     Exclude Pre-op appointments from reporting on an open pathway.  Include Pre-op appointments attended as reflects activity undertaken.

•     A separate workstream is currently developing best practice for SOS/PIFU. Handling of SOS/PIFU to remain as is for ECM reporting, acknowledging that there may be inconsistency across health board areas given that WPAS reporting includes such activity where See on Symptom records have a Target Date assigned.

•     Include Walk ins to Emergency Clinics where the result of the walk in has led to a subsequent referral, from an Open Pathway.    Include Walk ins to Emergency Clinics appointments attended in reporting as reflects activity undertaken.

•     Exclude Private patients from reporting on an Open Pathway.  Include Private patients’ appointments attended as reflects activity undertaken.

•     Exclude Ophthalmology day cases and inpatients from reporting on an open pathway as Eye Care prioritisation applies to outpatient referrals only. Exclude Ophthalmology day cases and inpatients appointments attended as Eye Care prioritisation applies to outpatient activity only.

Health Risk Factor

Assigned by the clinician, this categorises the risk to the patient’s eyesight if the Target Date is not met. It has three codes (R1, R2 and R3).  This, along with Invite Priority, is used to calculate a Weighted Priority Factor for use in the management of waiting lists.

R1:  Risk of irreversible harm or significant patient adverse outcome if target date is missed. 

R2:  Risk of reversible harm or adverse outcome if target date is missed

R3:  No risk of significant harm or adverse outcome

No Allocated HRF: A Health Risk Factor has not yet been allocated. As Health Risk Factor is a mandatory field within this solution it is anticipated that data will be minimal within this measure.

Invite Priority

Created to support waiting list management, this has values of

1 – Late – needs to be seen – must book

2 – Late but within 20% of Target date - book

3 – Ideal - book

4 – Early but acceptable to be booked

5 – Too early – do not book

Percentage Overrun

This is a calculation to provide guidance to a user as to the sequencing and order in which to see the patient.

Priority Type (New Patients)

Routine (Code 1) and Urgent (Code 2) will be deprecated for the Ophthalmology specialty where the new clinical prioritisation process has been applied. In such cases, Codes 1 and 2 will be replaced with Personalised Target (Code 4).

Target Date

The date on which the appointment (new or follow up) should occur.

Open Pathways

Outcome Measure

Definition

Total number of pathways without a target date allocated waiting at the end of the month (end of month snapshot)

This is the number of pathways (new or follow up) without a Target Date at the end of the data month. As Target Date is a mandatory field within this solution it is anticipated that there will be minimal data within this measure.

Total number of pathways within target date at the end of the month (end of month census snapshot)

This is the number of pathways (new or follow up) not beyond target date at the end of the data month and therefore includes pathways at target date.

Total number of pathways beyond target date (end of month census snapshot)  - split by %

This is the number of new or follow up patients who are waiting beyond their target date at the end of the data month, split by the wait beyond that target date. 

This measure also includes hospital cancellations, CNAs and DNAs where these are still categorised as waiting according to RTT rules. This additional wait is calculated as a percentage.  For each pathway, the method for calculating the percentage wait beyond the target date can be described as follows:

          If:       Census Date = A

                    Target Date = B                                                          

                    Original Outpatient Attendance or Referral Date = C

          Then:                                                                                                                                                                                                                                                                                                                                                                     

          For example:                                                    

If:       Census Date = 15th December 2018         

Original Outpatient Attendance = 1st November 2018

Target Date = 1st December 2018                     

Then:                                                                         

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

Total number of open pathways on the combined waiting list at the end of the month 

(end of month census snapshot)

This is the total number of open pathways (new or follow up) at the end of the data month.

This is an automatic calculation summing column C Total number of pathways without a target date allocated, column D (Total number of pathways within target date) and column I (Total number of pathways beyond target date).

Appointments Attended

Outcome Measure

Definition

Total number of appointments attended during the month - split by no allocated target date, within target date and beyond target date (monthly count) split by %

This is the total number of appointments (for new or follow up patients) where the patient was seen by the relevant member of the clinical team during the month and who were either at/within their clinically advised target date or beyond their target date split by the wait beyond that date. 

The relevant team member can be a consultant, nurse, orthoptist, optometrist and the setting can be in secondary care, primary care or within the community, including ODTCs.

With No Allocated Target Date provides a count of appointments attended during the data month where those patients had not been allocated a Target Date. As Target Date is a mandatory field within this solution it is anticipated that there will be minimal data within this measure.

Within Target Date provides a count of appointments attended during the data month where that appointment was at or within target date. This is the actual target date and does not include any permitted tolerances.

Beyond Target Date provides a count of appointments attended during the data month where that appointment was beyond target date. This is the actual target date and does not include any permitted tolerances. For each appointment attended, the method for calculating the percentage wait beyond the target date can be described as follows:  

For example:      

New Activity     

If:  A = Target Date (Taken from initial referral)

     B = Seen Date (Taken from treatment)

     C = Referral Date (Taken from referral)

Then:

Follow-up Activity

If:  A = Target Date (Taken from previous treatment)

     B = Seen Date (Taken from current treatment)

     C = Previous Seen Date (Taken from previous treatment)

Then:

Total is a sum of all patients seen within the data month i.e. With No Allocated Target Date + Within Target Date + Beyond Target Date

Number of appointments where patients cancelled or declined - originally within the target date and total

A count that is included for context. For all new or follow up patients who attended appointments beyond their target date at the end of the data month, this highlights the count of those where the patient had accepted a reasonable offer that was within TD but subsequently the patient DNA or CNA.

As this is an activity measure, this reflects number of appointments cancelled or declined as opposed to number of patients. Definitions for CNA are as per RTT Rules

Total number of appointments where patients did not attend

As this is an activity measure, this reflects number of appointments where patients did not attend as opposed to number of patients. Definitions for DNA are as per RTT Rules.

Note - The measures recorded for Total number of appointments where patients cancelled or declined and Total number of appointments where patients did not attend do not include all scenarios where the appointment agreed has not been met e.g. where the patient is deceased, where the hospital has cancelled the appointment etc.; consequently, the total of these two measures are not representative of all non activity