When ‘Appointment Request’ is selected as the request type, then the appointment type in the service details shrub will be active as there are booking requirements in the request type selected. Appointments can be set up using either ‘Diagnostic’ or ‘First Outpatient’ appointment type.
Diagnostic appointment type
This should be thought of as the default appointment type for diagnostic services. It allows the service to be configured to support either a ‘direct to test’ or a 'clinical assessment' model. It is therefore important to consider how the service will operate.
Direct to test model
This allows the referral to be accepted straight into the service (or re-directed/rejected as necessary). For example, a Bone Density Scan service would use the ‘Diagnostic’ appointment type, with the service provider clinician simply reviewing the clinical information (rather than clinically assessing the patient) before accepting, re-directing or rejecting the referral.
To enable this option, service definers will need to select ‘No’ for ‘Supports assessment/onward referrals’ option in the assessment capability section of the service definition screen. If this is not done, the full two-stage assessment service functionality will be enabled, as detailed below.
Clinical assessment model
There may be cases where a provider wishes to assess the referral before deciding on an appropriate test or other onward pathway. In such cases the ‘refer on’ functionality, (usually associated with the ‘Assessment Service’ appointment type), can be utilised within the ‘Diagnostic’ appointment type. This will allow the service provider to review the request and refer the patient on to another service. For example, a request to a Colon Imaging Advice service may result in an onward referral to a Colonoscopy, CT Colonography, Barium Enema or a Flexible Sigmoidoscopy service.
The assessment service model can also be used where the diagnostic test forms part of an assessment that will determine the onward referral pathway. In this case, the clinician, after carrying out the test, will decide with the patient what the most clinically appropriate onward pathway would be. For example, the result of a Urodynamics test carried out as part of a diagnostic assessment appointment, could determine an onward referral to either a Urology or a Gynaecology service (or the patient could be referred back to their referring clinician with the results of the test).
In order to utilise the referrals for assessment worklist, service definers will need to select ‘Yes’ for ‘Supports assessment/onward referrals’ option in the ‘Assessment Capability’ section of the service definition screen.
First outpatient appointment type
This should be used for services led by a consultant, carried out in an outpatient setting. It may be that diagnostic tests are carried out as part of this appointment, but the referral is essentially to a consultant-led outpatient service, not to a diagnostic service. For example, a referral to a first outpatient Urology one-stop service may result in the patient having one of several diagnostic tests (e.g. urodynamics or ultrasound) as part of the initial consultation with the consultant.