Outpatients' booking systems: an interim Healthwatch report

Healthwatch Brighton and Hove launched a project in 2020 to understand patients’ experiences of outpatient appointment booking services. Working with the local NHS Trust and Clinical Commissioning Group, Healthwatch gathered the views of 120 patients and visited outpatient departments at local hospitals. The work took place against a backdrop of rising demand for outpatient services, long waiting times and high numbers of missed appointments. At the time, the local Trust was seeing more than 50,000 outpatient attendances each month and was struggling to meet the 18-week referral-to-treatment target consistently. 

The project identified problems with appointment booking processes, patient communications and referral management. Healthwatch raised concerns about confusing or contradictory letters, difficulties contacting services and patients not receiving the information they needed at the right time. A case study included in the report described a patient receiving conflicting advice and multiple appointment letters, resulting in delays to treatment and considerable frustration. Healthwatch worked closely with commissioners and providers to highlight these issues and provide real-life examples of the impact on patients. 

As a result of this work, providers reviewed and redesigned patient letters to make them clearer and easier to understand. The Trust also introduced an online patient portal, expanded options for cancelling and changing appointments online, improved processes to reduce appointment backlogs and introduced additional systems to support patient choice and communications. Healthwatch was invited to join outpatient improvement groups and contribute to service redesign work. 

Healthwatch concluded that relatively small improvements in communication and administrative systems could have a significant impact on patient experience. The report highlighted the importance of clear, timely information, reducing appointment backlogs and improving patient choice. Although publication of the full findings was interrupted by the COVID-19 pandemic, Healthwatch intended the work to inform future outpatient transformation plans and support the NHS Long Term Plan's ambitions for modernising outpatient services.