Reducing Unnecessary Follow-Ups: Let’s Schedule with Need Not Time

The NHS was founded on the principals that healthcare should meet the needs of everyone, should be free at the point of delivery, and be based on clinical need not ability to pay. But, when it comes to follow-up appointments (when a patient has had their initial consultation and is invited for a follow-up as part of the same course of treatment) care is usually prioritised based on time, rather than clinical need.

Figures from thenational databasecovering the financial year 2016/2017 suggest that there are 2.2 follow-up appointments for every new appointment attended across NHS England - this adds up to over 62 million follow-up appointments.

Here at DrDoctor we believe that roughly 30% of these appointments are unnecessary. We think that there is a huge opportunity to not only transform the efficiency of our health service but to improve access for those who need it most at the same time.

Every hospital appointment offered to a patient should be appropriate. Scheduling should be based on fulfilling all the conditions of who, when and where. To get the right patient to attend the right appointment at the right time we need to look at other parameters. Does the patient have all the information they need to ask the right questions and turn up in the right place at the right time? Is the appointment timely, i.e. there’s no point in a follow-up control in six years’ time when the patient has been well for four years by the time the date comes around.

In an ideal world, patients would be seen when they are sick, the appointment would be value adding clinically as well as for the patient and the appointment would take place when it suits the patient logistically.

Unnecessary appointments result in a huge volume of low value interactions between clinicians and patients. This leads to low patient engagement and means patients who need care are left waiting longer than necessary. Patient experience is greatly improved when all interaction with clinicians adds maximum value, rather than requiring multiple appointments to collect and re-collect information.

At DrDoctor, we are developing the tools to reduce the number of unnecessary follow-ups, helping patients to receive the care they need, not the care they’re scheduled to receive. And allowing Trusts to reduce workload and avoid wasting their budget in nonsensical operation that benefits no one. We can help Trusts use clinical sources effectively to see which patients need to be seen sooner and/or with more frequency. We can help to reduce clinical risk and variation in practice through having clearly defined pathways, full visibility, and rigorous criteria for follow-up activity.

Setting a clear system that can easily be monitored and implemented in different departments allows for a flexible digital solution that can serve the changing needs of the Trust and is easily scalable across all specialties.

Reducing unnecessary scheduling improves Trust performance against targets and reduces operational strain on both clinical, and clerical staff. With the help of DrDoctor, time taken to process a booking is cut down by two thirds.

If you want to reduce follow-ups effectively you need comprehensive information. You need to know how your patients are doing, are they getting worse or is their treatment working? The problem for collecting this information has always been administrative cost - but remote, digital solutions offer an opportunity to solve this problem. Additionally, you need patients to be engaged. They need to provide relevant information that you require to make decisions.

That is where DrDoctor comes in, over the past six years we have been developing solutions to digitally onboard patients onto our patient portal - and now patients can provide more information about their health and wellbeing. This allows patients to gain agency over their own health and allows hospitals to ultimately cut down cost and drastically improve efficacy.