Agenda item - Brighton & Sussex University Hospitals Trust (BSUH): Waiting Times

Report of the Executive Lead, Strategy, Governance & Law, on Brighton & Sussex University Hospitals Trust (BSUH) waiting times and outpatient services

39.1    The report was presented by Ben Stevens, BSUH Director of Operations. Mr Stevens gave an overview of the outpatient services system at the Royal Sussex County Hospital (BSUH).

39.2    In response to a question from Cllr Morris on weekend appointments, Mr Stevens told members that weekend appointments helped the Trust manage demand effectively across the week. It was also the case that they are more convenient for many people.

39.3    In answer to a query from Ms McCabe on the impact of cancellations on the 18 week Referral To Treatment (RTT) target, Mr Stevens told the committee that the clock for this target starts as soon as a GP referral is made and is not halted or re-set by cancellations.

39.4    In response to a question from Cllr Marsh as to whether over-booking appointment slots had been considered, Mr Stevens informed members that this is an option discussed with clinics. However, the best way to improve efficiency is to reduce the number of appointments that patients do not attend (DNA). A detailed interrogation of DNA reasons will form a key part of the Trust’s outpatient improvement programme.

39.5    Cllr Morris commended BSUH for signing the transgender and non-binary protocol and asked how the Trust was communicating this to the local LGBT community. Mr Stevens agreed to provide a written response to this question.

39.6    In response to a question from Cllr Morris on how patients with dementia or mental health problems are supported to navigate the outpatient system, Mr Stevens agreed to provide a written answer.

39.7    In answer to a query from Ms McCabe on the role of Optum, Mr Stevens agreed to provide a written answer.

39.8    Ms McCabe noted that she found the volume of calls handled by the outpatient department worrying. Lots of people report to Healthwatch that they have been unable to contact outpatients because calls are not answered or the line goes dead. This must feed into the high percentage of DNAs.

39.9    In response to a question from Ms McCabe on the impact of the Clinically Effective Commissioning (CEC) programme on RTT targets (e.g. in instances where a treatment pathway has been amended so a period of conservative treatment must precede a referral for surgery), Mr Stevens told the committee that the impact on BSUH would be minimal as the RTT clock starts only on referral to acute services rather than when conservative treatment under the supervision of primary services begins.

39.10  Mr Stevens told members that he was happy to engage with Healthwatch Brighton & Hove to get patient perspectives on plans to re-design outpatient services.

39.11  In response to a question from Cllr Janio as to whether the Trust uses behavioural insight tools (e.g. writing to DNA patients to inform them how much a missed appointment has cost the NHS), Mr Stevens confirmed that the Trust does contact patients who have not attended appointments, and where appropriate may refer them back to their GP for further treatment. However, BSUH does not currently communicate the cost of missed appointments.

39.12  In answer to a question from Cllr Greenbaum on assessing the suitability of GP referrals, Mr Stevens noted that this was principally a commissioner role. However, the Trust does look at referral patterns from GP practices.

39.13  RESOLVED – that the report be noted.