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PKB supports trusts' elective recovery plans for Waiting List Validation (WLV) with our understanding that WLV is about capturing more and better data about patients waiting on lists. PKB’s questionnaire tool allows trusts to technically validate a patient's status, identifying any inaccuracies, such as patients who have moved out of the area, duplicated records, or patients already on a treatment pathway.

The trust team removes any patient no longer needed on the list, thereby ensuring the waiting list is accurate and up to date and allowing other patients waiting to be treated quicker by utilising appointment slots in the trust and surrounding hospitals.

Trusts can use PKB to validate patients regularly using the questionnaire tool, checking if they still need to be on the list, who can travel to other surrounding hospitals for their appointment and who is available at short notice if there are DNAs, ultimately reducing the overall list.

Current Problems

  • Long waiting list

  • No process to discuss any changes to the patient's condition

  • Unknown deterioration resulting in emergency admissions

  • Resulting in more money and time being wasted

  • Bad patients and clinical teams experience 

  • Patients are not always fit for surgery 

  • No education or support for patients

  • Paper and phone-based approaches are not fit for purpose

PKB solutions

  • Contacting patients to see if they still need the op, via an automated questionnaire

  • APIs to trigger sending and extracting back to PAS/EPR/Dashboard

  • Questionnaires issued at various times of a patient’s pathway (confirming they still need an appointment)

  • Remove people who can be removed

  • Collect data to determine if someone's position on the list has changed (i.e. have they deteriorated)

  • Ability to collect better data about who is best to offer the last min cancellations

  • Collect data about who is willing to travel to other locations so they can be seen quickly

  • Give trusts the ability to contact their waiting patients more often, improving patient experience as they know they haven't forgotten and don't need to chase

  • Empowering staff to use digital solutions, increasing resilience and adaptability

  • Digital workflows that are scalable around all specialities

  • The digital solution for all NHS elective recovery pathways, further info here.

  • Waitlist management for Emeet and Greet, Waiting well, WLV and digital decision support tool care plans

Use cases 

Mid Yorkshire Hospitals NHS Trust

Completed a trial implementing tailored Waiting List Validation Questionnaires sent to patients via PKB across 14 clinical specialities. With patient response rates of 50-80%, they achieved an immediate 6% reduction in the waiting list and an estimated £14,000 saving in clinical costs if the patients who were discharged had missed appointments. With proven positive impact, this is now being expanded across more specialities, integrating automation for more effective pathway management.

  • 94% asked to remain on the waiting list

  • 48% of patient responses were via PKB

  • Speed and the ability to change the questionnaire

  • Longer-term waiting list management, giving patients information at every stage

Example Questionnaire

University Hospitals of North Midlands

As part of a nationwide programme, UHNM is using PKB APIs to trigger the sending of questionnaires to patients, gathering BMI stats from patients awaiting surgery. They use this data to decide whether their surgery is still okay to proceed, or whether patients need to be put on a weight management programme or delay their surgery.

Hywel Dda University Health Board

Have implemented a pre-habilitation programme for those awaiting orthopaedic surgery. Patients are given a personalised care plan 8 weeks ahead of their surgery, with week-by-week guidance to prepare for their procedure and the rehabilitation afterwards. The health board is now looking to spread this to support more individuals on the waiting list, and across more therapeutic areas. Read more about the HDUHB virtual orthopaedic prehabilitation programme here in NHS England's digital playbook.

Hull University Teaching Hospital

Key features 

There are key PKB features all services validating waiting lists can use to capture data. A list of them is below.

Questionnaires 

Teams can use PKB’s FHIR trigger API to automate sending questionnaires to service users. They can use PKB’s FHIR API to extract completed responses back into their Organisation's electronic patient record (EPR) for review.

Patients can initiate a questionnaire by clicking Start Questionnaire on their homepage or directly within the NHS App. Once completed the questionnaire can be sent to a professional or team.

Teams using the questionnaire tool can ensure the outcome of clinical reviews is recorded and the patient has a copy. Teams can also identify patients suitable for virtual appointments or PIFU.

New Advanced Questionnaires 

By the end of 2023, organisations will be able to use PKB’s new advanced questionnaire functionality, the features include:

  • Scoring and calculations

  • Branching, allowing patients to complete the parts of the questionnaire that are relevant to them

  • Coded fields, questionnaires can be mapped to clinical codes

  • Patients can save drafts

  • Send questionnaires to patients who aren’t registered or already in your team

Questionnaire templates

Messaging 

  • Patients have access to message their healthcare team (saving time on the phone)

  • The Admin team can triage messages. Either resolving or passing onto another speciality team

  • Universal Messaging is the ability for patients to message clinical and non-clinical teams

  • Team-based messaging allows teams to automatically receive secure messages and consultations as a group rather than as individuals

Library 

  • Waiting Well resources

  • Online patient leaflets

  • Support group information

  • Videos

Care plans 

PKB care plans can be used at every stage of a patient's condition journey, below are some of the care plan templates being used and templates that can be created.

Appointments 

  • Appointment letters and appointments sent to PKB via integration

  • Manually entered appointments

Workflow 

Validate the Trusts Waiting list in line with NHSE. 

Patients will be added to the team (set periods) and sent a Questionnaire asking if they are still wanting their appointment. Once the response is collected by the Trust they can Validate their waiting list and either discharge the patient from the PKB team or keep the patient in this team, sending a waiting list validation Questionnaire as needed and in line with NHSE guidelines. For those patients not registered in PKB, the Trust will send a digital letter to the patient's PKB record or SMS to encourage them to register for PKB and complete the waiting QA.

Point 10a to 4 is a process continually on a loop until the patient has their procedure.

SMART Goal

Reduce the number of missed appointments (DNA) for the rheumatology team by Sept 2023 (12 months post team go live) from (current missed appointments) to ( %) by sending all appointment letters and appointment details into PKB instead of by post. Current missed appointment rates are (%). 12 months post-going live, the team compared missed appointment rates of patients with and without a PKB record. It is a local NHS priority to reduce missed appointments to save money.

Further information

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