• Patients were referred electronically but could not be found an appointment slot
  • Patients dropped off list after 180 days
  • CCG says it is now confident problems have been resolved

A trust has been told to carry out harm reviews on 74 patients who disappeared from a waiting list after they could not be found an appointment slot.

Medway Clinical Commissioning Group asked Medway Foundation Trust to carry out harm reviews on patients who had waited more than 180 days to be found an appointment and find out why the number of patients affected by appointment slot issues at the trust was so high.

The trust said 42 reviews have been carried out so far with no evidence of harm uncovered.

Appointment slot issues

ASIs occur when patients are referred electronically but cannot immediately be fitted into an appointment slot. The referral is forwarded to the trust which should then find an appointment time for them.

Latest figures from NHS Digital for October 2019 show more than 292,000 patients were affected by ASIs overall, with about 2,000 in Medway. 

However, patients who are waiting to be allocated an appointment disappear from trusts’ ASI “workbooks” of outstanding patients seeking appointments after 180 days, making them less visible to trusts. But, in theory, they should all have been given appointments by this point.

Medway CCG, which is the trust’s main commissioner, had raised concerns in its latest governing body papers. It said that, although some ASI patients have been added to the normal patient administration system, “there is currently a lack of assurance that a sustainable process has been embedded to prevent a reoccurance”.

However, the CCG’s deputy managing director Stuart Jeffrey said this week: “A revised process is now in place to ensure future ASIs are managed in line with national guidance so we are confident the situation has been resolved.”

The trust said it had initiated “more robust” management and its ASI list was closely monitored to make sure patients did not “drop off”. There was a separate route in place for patients on the two-week referral pathway for suspected cancers.

The trust added: “When a patient is unable to book an appointment, due to there being no slots available, they are added to the ASI list. This list is accessible and managed by the operational teams at the trust which involves identifying, and in some instances, creating extra capacity. This can be a challenging situation and is dependent on other operational pressures as to how much extra capacity can be sourced.”