virtual outpatient clinic for outpatient follow-up appointments

66 Pages·2016·3.96 MB·English

by  Nicki Morrison

VIRTUAL OUTPATIENT CLINIC FOR
OUTPATIENT FOLLOW-UP APPOINTMENTS
Bibhas Roy
Consultant Orthopaedic Surgeon (Shoulder & Elbow)
Central Manchester Foundation Trust
Health Service Journal Top Innovator 2013
MIMIT, Manchester Interdisciplinary Biocentre
www.proms2.org

OUTPATIENT APPOINTMENTS IN UK
OUTPATIENT CLINICS; THE NUMBERS (DEC 2015)
o 107.2 Million outpatient appointments in 2014-15
o 85.6 (79.9%) Million were attended
o 25.9 Million first outpatient attendances (30.3%)
o Hence 70% of outpatients appointments are follow-ups
o Patients aged 65 to 69 had the highest number of attendances
http://www.hscic.gov.uk/searchcatalogue?productid=19879&topics=2%2fHospital+care%2fAdmissions+and+attendances%2f
Outpatient+attendances&sort=Relevance&size=10&page=1#top
Hospital Outpatient Activity 2012-13. December 12, 2013. Health and social care Information centre (HSCIC). http://www.hscic.gov.uk/catalogue/PUB13005
WAITING TIMES
• Patients should be seen within 30 minutes of their appointment time
• 74% for Trauma and Orthopaedics vs 85% for dermatology and
rheumatology.
Audit commission 2003. Outpatients - Review of National Findings. http://archive.audit-
commission.gov.uk/auditcommission/nationalstudies/health/other/pages/outpatients.aspx.html
NHS TARIFFS
CONSULTANT-LED TARIFF
WF01B WF02B WF01A WF02A
Treatment function name First Attendance - Single First Attendance - Multi Follow Up Attendance - Follow Up Attendance -
Professional Professional Single Professional Multi Professional
General Surgery 191 207 101 101
Urology 177 196 96 99
Breast Surgery 154 154 84 85
Colorectal Surgery 131 157 72 105
Hepatobiliary & Pancreatic 166 166 102 102
Surgery
Upper Gastrointestinal Surgery 140 140 82 82
Vascular Surgery 234 234 116 116
Trauma & Orthopaedics 137 137 83 83
ENT 114 141 63 73
Ophthalmology 115 138 67 75
2012-13 tariff information spreadsheet. https://www.gov.uk/government/uploads/system/.../dh_133578.xl
2016-17 Tariff - Outpatient Attendances
CONSULTANT-LED (£)
WF01B WF02B WF01A WF02A
First First Follow Up Follow Up
Treatment
Treatment function name Attendance - Attendance - Attendance - Attendance -
function
Single Multi Single Multi
Professional Professional Professional Professional
100 General Surgery 144 224 89 128
101 Urology 132 203 76 105
103 Breast Surgery 168 168 96 96
104 Colorectal Surgery 121 129 76 102
105 Hepatobiliary & Pancreatic Surgery 188 208 120 141
106 Upper Gastrointestinal Surgery 113 144 81 101
107 Vascular Surgery 166 177 105 119
Trauma &108 OSpinal Srurtgehry Seorvicepaedics 1162 291,62 13199 , 7799, 86
110 Trauma & Orthopaedics 129 131 77 86
120 ENT 107 168 66 92
130 Ophthalmology 113 125 64 94
140 Oral Surgery 119 185 75 128
143 Orthodontics 155 207 78 107
144 Maxillo-Facial Surgery 108 175 74 83
160 Plastic Surgery 114 152 66 101
170 Cardiothoracic Surgery 261 261 178 181
171 Paediatric Surgery 170 170 110 113
172 Cardiac Surgery 280 280 183 183
NHS 173 Thoracic Surgery 275 277 170 170
190 Anaesthetics 95 95 61 84
191 Pain Management 165 165 92 92
211 Paediatric Urology 173 304 144 207
214 Paediatric Trauma and Orthopaedics 145 145 94 109
TARIFF 215 Paediatric Ear Nose and Throat 107 168 66 92
216 Paediatric Ophthalmology 136 166 82 135
217 Paediatric Maxillo-Facial Surgery 128 212 128 188
219 Paediatric Plastic Surgery 137 194 105 105
223 Paediatric Epilepsy 213 213 170 170
251 Paediatric Gastroenterology 257 257 150 150
252 Paediatric Endocrinology 385 385 186 200
253 Paediatric Clinical Haematology 424 463 206 216
257 Paediatric Dermatology 130 201 94 165
258 Paediatric Respiratory Medicine 285 294 151 174
263 Paediatric Diabetic Medicine 203 207 95 111
300 General Medicine 183 259 108 139
301 Gastroenterology 183 259 108 139
302 Endocrinology 189 189 96 106
303 Clinical Haematology 288 463 120 216
306 Hepatology 183 259 108 139
307 Diabetic Medicine 203 207 95 111
320 Cardiology 166 230 96 148
321 Paediatric Cardiology 229 232 125 167
329 Transient Ischaemic Attack 306 306 - -
330 Dermatology 107 123 70 77
340 Respiratory Medicine 182 278 105 174
341 Respiratory Physiology 167 333 136 274
350 Infectious Diseases 322 327 209 209
361 Nephrology 269 313 128 241
370 Medical Oncology 209 215 93 102
410 Rheumatology 225 246 103 165
420 Paediatrics 222 235 135 156
430 Geriatric Medicine 245 245 137 137
502 Gynaecology 138 151 89 105
503 Gynaecological Oncology 160 203 96 108
800 Clinical Oncology (Previously Radiotherapy) 209 215 93 102
812 Diagnostic Imaging 0 0 0 0
ORTHOPAEDIC CLINIC COSTS - ENGLAND
• NEW Orthopaedic OPA
• 2,510,735 x 137= £343,970,695

• FOLLOW-UP orthopaedic OPA
(7,375,581 – 2,510,735) x 83 = £403,834,425

• TOTAL orthopaedic OPA
£343,970,695 + £403,834,425 = £747,805,120
9
OUTPATIENT APPOINTMENTS NOT ATTENDED.
Numbers Percentage
Attendances 85,631,701 79.9

Did not attend 7,442,949 6.9

Patient 6,595,051 6.2
cancellations
Hospital 7,057,145 6.6
cancellations
Unknown 461,577 0.4