Report to:

East Sussex Health Overview and Scrutiny Committee (HOSC)

 

Date of meeting:

 

3 October 2024

By:

Deputy Chief Executive

 

Title:

Missed NHS Appointments in East Sussex

 

Purpose:

To provide an overview of the work being undertaken to minimise missed appointments in secondary care (hospitals) across East Sussex.

RECOMMENDATIONS

The Committee is recommended to:

1)    note the report; and

2)    identify if there are any areas it wishes to scrutinise further.

1.            Background

1.1.        The Health Overview Scrutiny Committee (HOSC) at the meeting held on 14 December 2024 discussed the problem of missed appointments, and how it related to wider problems such as cost of living pressures, transport links and the postal service. The Committee agreed that it would be beneficial for a report on the topic to be brought to a future meeting, due to the impact of missed appointments on the capacity and best use of resources within the healthcare system and how reducing missed appointments may help the system reduce pressures and waiting times.

1.2.        This report covers a number of areas which the HOSC asked about when it considered requesting the report at its December 2024 meeting. It focusses on missed appointments in secondary care and uses evidence from missed outpatient appointments in the major disciplines as an example of the types of issues experienced and current performance in secondary (hospital) care.

1.3.        Missed appointments in primary care are addressed as part of a separate report on the agenda (agenda item 6) that is being presented to update the Committee on ‘Improving Access to General Practice in East Sussex’.

2.            Supporting information

2.1.        Across all NHS settings (primary care, outpatients, diagnostics etc) missed appointments are a daily occurrence. The consequence is wasted capacity within the system, which, at a time when health systems are under considerable pressure, it can ill afford. Missed appointments are reported nationally by healthcare providers to support understanding of the prevalence in different areas, as well as the common demographic characteristics.

2.2.        The report, which is attached as Appendix 1, outlines the work undertaken across Sussex to better understand why patients miss their appointments, and actions to reduce them. It focusses on missed appointments within hospital outpatient services at East Sussex Healthcare NHS Trust (ESHT), because a considerable proportion of activity is undertaken in this setting, but it recognises the causes and possible mitigations can be applied across the full range of settings.

2.3.        The report includes details on:

·         An analysis of missed outpatient appointments at ESHT and a comparison of missed appointment rates with other providers.

·         Information on the performance of ESHT (the main hospital provider in East Sussex) in reducing the number of missed appointments.

·         Work undertaken by NHS Sussex with Healthwatch Sussex (a collaboration between Healthwatch Brighton and Hove, Healthwatch East Sussex, and Healthwatch West Sussex) to better understand the drivers for missed appointments and the barriers to attending appointments, including the key findings from this work.

·         The actions underway at ESHT to minimise and address missed appointment rates, which include:

o   Two-way text reminders to remind patients of their appointments and give them an opportunity to confirm their attendance or request to change/ cancel.

o   A short notice appointment service is being offered to try and minimise appointments not being utilised.

o   Reviewing and updating the Elective Access Policy to provide further clarity around missed appointments and how they are managed.

o   Undertaking a review of appointment letters to ensure they are clear and concise for patients in line with the findings from the work with Healthwatch.

o   Undertaking deep dives into nine of the larger specialties to better understand the drivers for missed appointments to inform specialty level action plans. Part of this work will also focus on better understanding missed appointments from an economic/social lens.

o   Reviewing different patient engagement tools that will allow more sophisticated and flexible communication with patients regarding their appointments.

 

3.         Conclusion and reasons for recommendations

3.1       The HOSC is recommended to note the report and consider whether it would like to add any future updates or further work on missed appointments to its work programme.

 

PHILIP BAKER
Deputy Chief Executive

Contact Officer: Patrick Major, Scrutiny and Policy Support Officer
Tel. No. 01273 335133
Email: patrick.major@eastsussex.gov.uk