Patients to book own hospital appointments with backlog-busting NHS app

·5-min read
Under new plans, everyone on waiting lists would be able to contact hospitals directly, via the NHS app or phone - DANIEL LEAL-OLIVAS/AFP
Under new plans, everyone on waiting lists would be able to contact hospitals directly, via the NHS app or phone - DANIEL LEAL-OLIVAS/AFP

Patients will be able to book their own hospital appointments under a "game changing" plan to restore confidence in the NHS, a senior health official has revealed.

The overhaul is part of radical efforts to tackle record waiting lists, with almost six million people now waiting for treatment, and fears the figure could more than double as more come forward.

Under the plans, everyone on waiting lists would be able to contact hospitals directly, via the NHS app or phone. But millions of routine follow-up appointments are likely to be axed in an attempt to prioritise those most in need.

Health officials say the national scheme would “give the power back to the patient” and mean doctors spend less time on “pointless” appointments.

Four in five people now on waiting lists are waiting for hospital appointments, rather than surgery.

Officials say two in three of those waiting for outpatient consultations are “review” checks - which are routinely scheduled every six months for millions of people with long-term conditions, whether or not they are needed.

Under the new scheme expected to be announced next week, patients who are referred to hospital by their GPs would be given “direct access” to their medical team, enabling them to book a slot at a time that suits them and seek advice about their condition.

Officials say the system, which they want to introduce “at industrial scale” across the health service, will provide patients with far more information, including how long they will have to wait to see a doctor. It could also allow patients to schedule tests.

Watch: Coronavirus in numbers: UK total cases pass 10 million

The plans, now under consideration by ministers, would also mean that follow-up appointments are not given automatically. Instead, patients would be told to contact medical teams if their condition flares up, or they need advice, with consultants encouraged to provide far more advice by phone and online methods.

Sir Jim Mackey, a hospital chief executive, who has been appointed to advise NHS England on the national “elective recovery” plan, said radical measures were needed to rebuild public confidence in the NHS and reduce waiting times.

He told a seminar of NHS managers: “It's the biggest financial intervention for a very long time and the expectation that comes with it does feel very, very significant.”

“We're all seeing a really material change in public attitude this year versus last year,” he warned, saying the public had been “very tolerant” and “probably too understanding” in attempting to reduce pressures on the NHS during the pandemic.

“Now they need to get seen, they want to get seen ... It's a manifestation of the public really needing to get things sorted out that they feel they are being deprived of.

“We must remember at all times the NHS is their service. It’s owned by the public, and we think we forget that at our peril.”

Sir Jim, who is the chief executive of Northumbria Healthcare NHS foundation trust, said it was “fundamentally wrong” that patients are given so little information after being referred to hospital - including how long they will have to wait.

“There is no interaction that gives them confidence of where they are in the queue and what's going to happen next,” he said, outlining plans to “give the power back to the patient”.

Ministers are expected to announce plans to tackle the waiting list backlog next week, with schemes drawn up by Sir Jim and Sir Michael Barber, the former head of Tony Blair’s delivery unit.

Watch: Are health apps any good?

Sir Jim told a webinar run by the Health Foundation that the plans would require radical changes in order to succeed, such as direct access to hospital teams and axing of routine follow-up appointments.

“We have to find two or three game changers because if our only messages to our staff are that we're going to get out of this by working 20 or 30 per cent harder than you've ever worked, we will not be able to control the retirement rush,” he said.

“We have to take the opportunity to find a way of changing the game. And I think changing the game is about giving the patients more power and control over their access, their interactions, the decisions that affect them.”

Too many follow-up appointments were “a waste of time” which were “pointless” for patients and doctors, he said, saying a system of "patient-initiated follow-up" should replace automatic checks with access to medics when patients were concerned.

“It also potentially frees up a huge amount of clinical time .. so I think that's going to have to be a big part of our plan,” he said in the webinar last month.

However, Sir Jim stressed that the system would need to ensure all patients could access it, amid concern that too much reliance on apps could create “digital exclusion” where the elderly and vulnerable struggle to get help.

Officials are also understood to be discussing whether patients should be encouraged to travel for care. Patients are already allowed to choose a hospital for treatment, which could be anywhere in the country, but the policy has little take-up. Future schemes could see a “clearing houses” set up so patients who were happy to travel could cross the country for hospitals with lower waiting lists.

Sajid Javid, the Health Secretary, has warned that waiting lists are likely to surpass six million by the new year, and could reach 13 million, as more people who stayed away from the NHS during the pandemic come forward for help.

On Wednesday, a government source said: “The elective recovery plan is still very much in development, decisions haven’t been made and there is some way to go before things are signed off.”

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