Patients’ views: Surveys of east Kent outpatient services were carried out in February 2011 and in May 2013, when 75 per cent of patients indicated they would be prepared to travel to another of the Trust’s hospitals if they could have their tests on the same day as their appointment. Full details of the survey results are available on www.ekhuft.nhs.uk
The results of both surveys showed that:
- 80 per cent of patients who responded attended their outpatient appointments by car
- 70 per cent said they would be prepared to travel to one of the Trust’s other hospitals if they could have their tests on the same day as their clinic appointment with the clinician
- more than 34 per cent would prefer to have their appointments before or after the normal working day
- 75 per cent would like a Saturday appointment.
As a result of these surveys, the Trust also knows that many people want their outpatient appointments to involve less time waiting to be seen and a much wider choice of clinic appointment times, including early mornings, evenings and weekends. It also recognises that on occasions the clinics run late and patients have to wait for their appointment.
In a separate survey in September 2013, outpatients were asked for the top three improvements they would make to the service. Common themes in the responses included:
- reducing waiting time for appointments
- improving the timing of clinics
- having adequate seating
- better parking
- tea/coffee facilities.
This survey also showed that more than 90 per cent of the patients who responded were in favour of having their assessment, diagnostic tests and treatment plans on the same day and 80 per cent were in favour of extended outpatient clinic hours, in mornings, evenings and weekends.
Travel times: The Trust mapped where patients are travelling from for their outpatient appointments. Currently a total of 215,469 patients travel more than 20 minutes drive time for their clinic appointment and often have to visit several different sites for their assessment and treatment.
We think this needs to improve. We also know that, as only a few specialities are offered from some of the 15 sites, many patients have to travel to other sites for their clinic appointment.
Time taken to gather all necessary information for diagnosis: Currently, when outpatient consultations happen, clinicians are able to ask patients about their symptoms and carry out a physical examination but then have to ask them to go on a separate occasion to one of the few places where the tests and images can be done.
The patient then has to return another day to discuss the results once they are known. This can take several weeks and the full range of consultations and investigations can often stretch over a month or more. Patients end up spending many more weeks than necessary waiting for each of these appointments.
Some patients may also have to come back to an outpatient site for a further follow-up appointment or because they need some diagnostic tests such as an X-ray or blood tests. Others have to return for pre-operative assessments. This means there are a large number of patients who, at present, have to make numerous journeys as part of their outpatient care.
Equipment required: Very few of the 15 clinics where outpatient services are currently provided have the full range of equipment to help clinical staff diagnose people’s illnesses – or the space for modern one-stop clinics.
The Trust would like to develop a one-stop approach to its outpatient services so that, over the next few years, increasing numbers of patients can have all their appointments on a single day – but it can only achieve this if outpatient appointments are held on the sites that have enough space and the right equipment to provide a full range of services.
Outdated facilities: A number of the outpatient locations that the Trust is using need modernising so that they can provide a welcoming environment for patients and relatives and, importantly, support the proposed new ways of delivering outpatient care and treatment.
The Trust knows that some of the outpatient facilities it owns and others that it is using (but which belong to other NHS providers) are below the best standard. This can result in clinic waiting areas being too small for the number of patients being seen, as well as meaning clinicians do not have all the modern equipment or technology they need to care for patients.
Certainly, most of these facilities are not equipped with the kind of technology required for modern healthcare and they lack the capacity to provide the one-stop outpatient clinics.