Patient booking window/same day appointments

In February 2020, functionality was introduced for service definers to set a ‘booking window’ for each clinical priority that the service supports when defining a service using the NHS e-Referral Service (e-RS). This option also supports:

1. same day appointments - allowing appointments on the current day to be offered
2. an "end date" for appointments being made available - this could be especially useful for allowing providers to define a target ‘urgent’ waiting time
3. services with multiple priorities to only show appointments relevant to the priority without the provider having to create new services. This means all available appointments (including cancellations) in the time window will be visible for the relevant priority only.

This can be set up using the Service Priority, Patient Booking Window and Indicative Wait Time Calculation reveal (renamed from the Service Priority, Slot Protection and Indicative Wait Time Calculation’ reveal) shown below:

Service definers are able to set a start date and an end date for polling for each priority individually. These dates can be set starting as little as one hour ahead and there does not have to be an end time/date, although if no end date is set only the appointments up to the end of the polling range end date will be displayed. 

Any appointments outside of the patient booking window cannot be seen by the referrer, the patient or the appointment line (TAL). However, the provider could still book the patient into any slot (any priority), even outside the booking window.

Slot reservation can still be applied to services. This allows services to create new slots, at any time inside or outside of the patient booking window and these slots will be reserved for the next one or two days, depending on the value set. This is usually done to give the provider a chance to be able to book into newly polled slots, before they become accessible outside of the organisation. 

Service slot protection settings prior to the change in February were retained and became the start date for the booking window. Providers did not need to take any immediate action a; booking window settings were updated to match any previous slot protection which was set. This means that any appointments outside of the patient booking window continue not to be seen by the referrer, the patient or the appointment line (TAL). However, the provider can still book the patient into any slot (any priority), even outside the booking window.

Below are three examples of how the booking window could work. The scenario used is for a cardiology service that provides rapid access, urgent and routine appointments.

Example 1

A provider sets a patient booking window of two hours to 10 days on their two week wait priority. They exclude Saturday and Sundays as the service does not run on a weekend. The polling range for this service is 100 days.

At 09:00 hours on Monday 1 September a referrer is looking for a rapid access appointment.

As you can see on the above, all slots from 11:00 hours on the 1 September can be booked by referrers/patients/TAL (as shown in green). This is considered day zero in the patient booking window with day one being on the 2 September. The patient booking window goes over the ten days excluding the weekend so Saturday and Sunday (shown in red) cannot be booked by anyone. The slots remain available to referrers/patients and TAL up to day ten which is the 15 September. If there are no appointments in that booking window the referrer will be able to defer to the provider so they can manage it in the desired time frame. Any appointments after that, shown in orange, can be booked by the provider until the end of the slot polling range which will extend beyond the diagram to 100 days.

Example 2

This demonstrates both urgent and routine referrals. The provider has set a patient booking window from five days to 20 days for urgent appointments and from 14 days for routine appointments with no end date. These priorities only exclude Sundays because the provider has clinics on a Saturday. The polling range for the service is 100 days.

At 09:00 hours on Monday 1 September the referrer is looking for an urgent cardiology appointment. 

For the urgent appointments, from day zero to day four, only the provider can book available slots (shown in orange). Remember that we exclude the days that the clinic isn’t running which in this case is Sunday (shown in red). From day five, when the patient booking window starts for the urgent appointments, until day 20, when the booking window ends, slots can be seen by referrers/patients/TAL as well as the provider (shown in green) for urgent priority referrals. From day 21 until the end of the polling range, appointment slots can only be seen and booked by the provider.

For the routine appointments, from day zero until day 13, only the provider can book available slots (shown in orange). From day 14 until the end of the polling range (as there is no end date set), the slots can be seen and booked by referrers/patients/TAL as well as the provider (shown in green).

Example 3

The provider has set up an extra clinic to clear their appointment slot issues (ASI) waiting list.  The clinic itself is set up for the 18 September by a member of admin staff on the 1 September. The slot reservation period for this service is set to one day. 

For a referrer/patient/TAL staff member looking at appointments for this service on the 1 September, they will be able to see all of the slots as stated in example 2 but they will not be able to see the new slots on the 18 September, despite the fact that this falls inside the patient booking window for both priorities. This will give the provider a chance to fill the new clinic with patients from the waiting list. Any appointments still remaining in that clinic when the referrer looks for either urgent or routine appointments on the 2 September will now be shown as the slot reservation period has ended.  

University Hospital Southampton utilises the Patient Booking Window functionality within their services to support them to manage capacity, ensure the patient is booked into the most appropriate priority and at the right time to allow pre assessments to take place.

Support for this feature is available in the system Help.