Each year in the NHS there are ‘follow-up’ appointments where patients are asked to return to hospital to have their progress checked, to undergo tests, or to get test results. Whilst some of these appointments are clinically required, a large proportion are unnecessary. Reducing unnecessary follow-up appointments releases capacity for the treatment of new patient referrals.
This indicator looks at the ratio of follow-up appointments in relation to first appointments. A relatively high ratio could indicate that too many follow up appointments are taking place. It can assist trusts in ensuring that they achieve best practice in the level of new to follow-up appointments.
The indicator measures the number of outpatient follow up attendances that took place against the number of outpatient first attendances that took place. This includes Consultant, Nurse, Midwife, and other Care Professionals attendances, including Ward Attendances for nursing care
Follow-up does not have to mean that a patient is physically present with a healthcare professional. Telephone calls, questionnaires, web based services and group visits could be used to replace the traditional visit.
Follow-up appointments after treatment should take place in the right healthcare setting and be delivered by the appropriate healthcare professional. This means investigating alternatives to a consultant led hospital-based outpatient appointment. The first question should be “is a follow-up visit really necessary?” If it is, the assumption should be that the follow-up can be performed in a primary care setting and should be instigated by the patient. Automatic secondary care follow-up should be used only where necessary and clinically appropriate.
This indicator shows the opportunity for reducing the ratio of first and follow up outpatient appointments for providers. The productivity opportunity is calculated by applying the first follow up (FFU) ratio of the 10th, 25th or 50th percentile provider to the number of first attendances and applying the average follow up attendance tariff.
The following information is displayed for Managing New to Follow Up Outpatient Appointments.
First to Follow Up Ratio - Calculated ratio for the trust or treatment function
Financial Opportunity - The financial opportunity based on the quarter performance. Multiply by 4 to calculate annualised opportunity.
Volume Opportunity - Potential adjustment in attendance
Rank - Rank calculation based on first to follow up ratio within combinations of organisation type or Treatment Function and quarter of data.