Keeping slot poll ranges shorter than the actual waiting time for a service only results in patients being unable to book their appointment directly.
There are no RTT benefits to providers in keeping polling ranges artificially low, as the patient’s waiting time starts at the point that they appear on the appointment slot issues worklist (or earlier, if they have been through a primary care interface service or referral management centre).
Allowing the patient to book directly also has additional benefits; the provider has immediate access to referral information, the patient is automatically registered on the provider’s patient administration system (PAS) and the patient will also feature on the provider’s patient tracking list (PTL), highlighting RTT pressures and minimising the size of the appointment slot issues worklist, which can sometimes act as a hidden waiting list (as the patients are not on the PTL).
Keeping polling ranges long enough to enable patients to book while supporting organisations in their delivery of RTT requires good management of capacity and demand. Models for analysing outpatient capacity and demand have been made available by NHS Improvement.
Longer polling ranges can present challenges, particularly around the issue of consultant leave notification. The quotations below demonstrate how some providers manage this challenge:
Nottingham University Hospitals NHS Trust: “Most of our polling ranges go over six weeks. This does present a challenge in terms of the consultant leave policy. Most leave is booked well in advance by consultants but if leave is requested within the policy then if we cannot get another clinician to see the patients, then [patients] will be moved to the next available slot. Not an ideal solution but we are balancing two demands here”
Bolton NHS Foundation Trust: “The 6 week leave rule does on occasions cause us problems. We would use our firebreak clinics first, once used up we would ask for extra clinics. As a last resort we would do rolling moves.”
Royal Devon and Exeter NHS Foundation Trust: “Our wish is to move back to polling ranges of 6 weeks, but this is a gradual process as we resolve our capacity issues. We use our Registrars, SHOs etc. to cover consultant cancellations – where we can’t we will tend to shift all patients’ appointments back. However, this is rare”.