Patient Access Policy

THE ACADEMY OF COMMUNITY HEALTH EXPERTS

PATIENT ACCESS POLICY

Overview

ACHE is committed to developing systems and processes that seek to match demand and capacity for the services we provide. Efficient use of our facilities and service delivery is essential to ensuring smooth and effective delivery of services. 

Purpose / Aims of ACHE Service(s)

• To provide patient-centred, community-based services ‘ care closer to home’ that are safe, high quality with a good patient experience and reported outcomes.
• To provide the service in community settings accessible to patients of Leicester, Leicestershire and Rutland.
• To provide a means of improving health and quality of life by providing patient-centred, systematic and equitable treatment with effective clinical outcomes.
• To improve patient reported outcomes and experience, at the same time as delivering greater value for money for the NHS.
• To carry out all treatments within a maximum of 18-weeks from the date of referral.

Overall Objectives

• The objective of this policy is to ensure that ACHE works consistently, to a high standard and within the terms and conditions of the agreement with LLR PCL.
• Patients referred to ACHE will be offered choice of appointment dates and times, treated as soon as possible and within agreed timescales. 
• ACHE will promote efficiency and quality through the introduction of good practice, waiting list management systems and processes and emphasise individual accountability and responsibility.
• ACHE will treat patients within the agreed timescales providing the best level of clinical care

Service Provision

ACHE is responsible for ensuring our services meet (or exceed) all of the service provision standards within our agreement with LLR PCL. Any actual or potential difficulties in achieving patient care targets. The appropriate service manager allocated to liaise with LLR PCL will then put in place recovery plans.

Patient Appointments

• Patients are advised that if their GP has referred them for treatment or diagnostic test(s), they are strongly advised to make their appointment a priority. 
• Patient attendance - Once the initial appointment is made, patients are responsible for attending appointments, advising ACHE of any changes of personal details, periods of unavailability whilst undergoing treatment and for notifying ACHE immediately if an appointment is no longer required or needs to be changed.
• Patient failure to attend an appointment can cause considerable difficulties to patient services; including increasing waiting times and service costs. Patients are therefore asked to ensure they contact ACHE, at the earliest opportunity, to cancel or re-book an appointment so that the appointment may be offered to a waiting list patient.
• Patients returned to referrer - Failure to attend 2 appointments may mean the patient is referred back to their GP.
• Patient Cancellations - Patients will be permitted to cancel and reschedule their first outpatient appointment once, however any subsequent requests to reschedule will entail a reasonable explanation and the reassurance that they are committed to attending all future appointments. Failure to comply may result in the cancellation of the referral and rejection back to the referring health professional or general practitioner.
• Patient’s Guide to NHS Waiting Times in England https://www.nhs.uk/using-the-nhs/nhs-services/hospitals/guide-to-nhs-waiting-times-in-england/#maximum

Patient Communications

Communications with patients will be informative, clear, concise and documented. ACHE will ensure we have materials available in a format and language suitable to our patients’ requirements and when necessary use an interpreting service.

Additional support for vulnerable patients - for example those with learning difficulties or dementia may be required to ensure all their specific needs are met.

All communications to patients will be provided quickly, with clear information and details of how to contact ACHE with and questions or concerns. The letters will include:

• Appointment site, date and time
• Details of any specific guidance for attendance on the day
• A patient information leaflet, Health Questionnaire (as required) and map
• Details of who to contact with regards to cancelling/rebooking appointments or requests for patient information in an alternative format/specific needs e.g. Interpreter
• Information regarding implications of not attending appointments without prior notice

Internal Operational Standards

All ACHE clinics are published on the e-referral system (Choose and Book) and are fully staffed and operational. To ensure this happens we have the following in place:

• Annual leave protocols are adhered to, ensuring that at least 6 weeks’ notice is given to reduce the impact on waiting times and rescheduling of booked appointments.
• Patients are offered a choice of appointments and locations for their treatment within the service wait time. If patients’ decline offered appointments a clear note of this and the reason is provided within the patient record.
• All decisions regarding the discharge of patients, including any subsequent clinical decisions are recorded on the electronic patient record and notified to the referring GP and patient within the specified timescales.

Referrals Process

All patients are contacted within 3 working days of referral receipt and offered a choice of site (where available), date and time to offer the best patient choice.

Patient Cancellations/Failure to attend

Patients will be permitted to cancel and reschedule their first outpatient appointment once. However, any subsequent requests to reschedule will entail a reasonable explanation and the reassurance that they are committed to attending all future appointments. Failure to comply may result in the cancellation of the referral and rejection back to the referring health professional or general practitioner.

Cancellation of Appointment or Procedure

Cancellation of patient appointments will only be made when all other efforts to continue with service delivery have been exhausted. As much notice as possible will be given to patients. 

We will aim to reschedule cancelled appointments in negotiation with the patient - offering the soonest and most convenient day/time. The rescheduled appointment will be confirmed in writing to the patient.

Wait time Guidance

The wait time guidance sets out a patient legal right to receive their first level of treatment within 18 weeks of the date of referral.

The wait time clock may stop when;

• first definitive treatment begins. This is defined as ‘an intervention intended to manage a patient’s disease, condition or injury and/or to avoid further intervention’.
• a clinical decision is made that treatment is not required
• a patient chooses to decline treatment
• a period of active monitoring (watchful wait) is commenced

Active Monitoring (watchful wait)

A clinical decision is made to start a period of active monitoring. In many pathways there will be times when the most clinically appropriate option is for the patient to be actively monitored over a period of time, rather than undergo any further tests, treatments or other clinical interventions at that time. When a decision to commence a period of active monitoring is made and communicated with the patient this stops the patients RTT clock.

Monitoring Effectiveness and Review

ACHE constantly monitors the effectiveness of the patient referral and booking services and ensures that records are diligently maintained.