1. Establish consultant availability Establish a single Appointment Centre Model clinical service delivery Focus on follow ups Focus on patient information Set Standards of Service Implementation Checklist Patients will be able to book their appointment at the point of referral. This will require providers to release appointments with a high level of assurance they will be honoured – the following steps are designed to help providers manage the challenge of releasing slots, particularly beyond 6 weeks

2. Set Standards of Service Ensure DNAs do not increase Target of a maximum of [X]% DNA rate in each service Improving the system Patients able to book their appointments within [X] working days of the decision to refer Patients provided with one number to call to make, rearrange and cancel Ensure referrals are received within [X] working days of the decision to refer Ensure referrals have been clinically reviewed within [X] working days of receipt Patients to receive a copy of referral information Patients to receive a reminder letters [X] weeks before the appointment Ensure hospital cancelled appointments do not increase Less than [X]% of all appointments cancelled and rebooked

3. Communicate the benefits of determining forward commitments; better patient service, improved clinic planning, more efficient system Establish consultant availability Review Annual Leave Policy with medical staff Co-ordinate team absence. Work with clinicians and medical secretaries to establish a single weekly forward load system of clinical availability. Agree with consultants who can review referrals or cover clinics in their absence Use trend analysis to model patterns of clinic delivery Focus on problematic areas

4. Log and Track all referrals and appointments through the Appointment Centre. Ensure referrals are received and reviewed within Standards of Service Provide one number for the Appointment Centre and an extended hours service in the evenings and weekends. Ensure IT functionality and appointment management functions are able to obtain and offer the next series of chronological appointments for each service in 13-week blocks. Use trend analysis and model clinic delivery to commission and offer an appropriate number of appointment types in each clinic. Focus on problematic areas Establish a single Appointment Centre

5. Where do referrals originate from? What resources were needed to support clinic delivery ? How many clinics were delivered and when? How many of each appointment type was delivered at each clinic? Who can see which type of appointment? Is there a pattern of clinic over run? Cancellation? Unused slots? Is there a pattern of annual leave, study leave and emergency cover? Model clinical service delivery

6. Partially book follow-ups to increase capacity and flexibility of clinics. Provide information on how to make / change appointments, what to expect, and the cost to the NHS of not attending an appointment Send reminder letters, giving enough time for appointment staff to fill the slot if the patient is unable to attend. Use letters, telephone, email and texts to contact patients and confirm attendance. If a patient DNAs contact the GP Focus efforts on specialities with high patient DNA rates Focus on follow ups Focus on patient information Provide one number for patients to call to make and change appointments, which is available at evenings and Saturday mornings.