Reduction in DNA rates post patient registration
Background
Patients missing appointments directly costs £700m every year according to the department of health.
Missed appointments also increase wait time, reducing the use of clinicians and administrative resources. Often, the patient still needs their appointment and therefore administrative time is required to reschedule this, and there is risk to conditions worsening in the meantime. Worse still, patients re-attend, often at less convenient times and in less appropriate settings such as A&E.
With the current backlog faced across the NHS, there has never been a more important time to make every contact count and maximise service delivery efficiencies. PKB has been working with customers to look at their strategies for optimising service delivery and has a variety of programmes looking at specifically improving patient outcomes.This all starts with registered patients to the platform, and this act of registration brings its own benefits in supporting the reduction of DNAs.
The data
Many show this reduction across the whole Trust and at large scale such as Hull University Teaching Hospital. Across the Trust, HUTHs DNAs are 8.74% for unregistered patients and just 5.61% for registered patients.
The difference is even more dramatic in some of our newer cohorts. East London Foundation Trust, a mental health provider, used PKB with a few hundred patients with severe mental illnesses. The programme has a DNA rate of 22.8% for unregistered patients vs 13.99% for registered.
The Benefits
Each DNA costs the NHS £120, and every reduction brings a cash benefit.Ultimately, this is about health. Patients who do turn up for their appointments, especially follow-up appointments for long-term conditions, are more likely to get more healthy. Services using additional features, such as personalised care planning and messaging are also seeing additional drops in inpatient admissions and A&E visits.
How PKB delivers these benefits
Appointments
PKB shows the patient scheduled appointment information, often immediately. PKB also shows the data as soon as the appointments team schedule any changes to the appointment. The display is also clear, with the latest time,date and location. Out of date appointment information is hidden, avoiding the confusion of patients who get appointment letters out of sequence. For patients with multiple appointments, or appointment changes, there is no confusion in which appointments are when.
As one user noted:
“I have had twelve appointments with the seven separate NHS positions. I have actively managed the appointments schedule, checking sequencing as soon as a NHS appointment is entered by a member of NHS staff. For example, checking for myself the best time to attend a blood test for the results from lab to arrive in time for a specialist appointment.”
Letters & Documents
PKB also shows letters about the appointment. PKB notifies the patient twice, once for the appointment and once for letter. The letter adds important information about the appointment, such as instructions on eating/drinking. Over 50% of patients read their PKB letters within 2 hours, and 83% within 2 days. If a letter is not read within a day, PKB reminds the patient to look at it.
Appointment Managment
If a patient does need to rearrange or cancel an appointment, it is much easier for them to know who to contact if they can access these details quickly and easily through their digital platform, without having to keep hold of and find their physical letters.
This September PKB’s newest functionality supports further streamlining of requests to cancel and change appointments. This reduces the number of unplanned phone calls a service has to deal with to allow administrative processes to be streamlined through asynchronous messaging. More information can be found here.
Carer
Carers can access a patient’s PKB record. When new appointments or letters are shared in the record, PKB notifies the carer as well as the patient. These carers can be added by the patient or by a professional on a patient's behalf. Carers using PKB can help the patient reschedule, remember and attend the appointment. Increasing the ease of visibility of appointments to carers makes this easier for all.
