Joyce Wardrope Health Information Consultant

1. 18 Weeks Referral To Treatment Waiting Times Standard Joyce Wardrope Health Information Consultant

2. RTT - Whole Journey From date referral received to date of commencement of definitive treatment Inclusive of: OP attendance + DC/IP procedure

3. Current ‘Stage of Treatment’ Measures OP Diagnostics IP/DC 12 WEEKS 4 WEEKS 9 WEEKS

4. Current ‘Stage of Treatment’ Measuresfor Cancers Urgent Suspicion of Cancer (USC) referral • 62 days from date referral received to commencement of treatment Routine referral • 31 days from decision to treat to commencement of treatment Both are whole journey measurements

5. Existing Stage of Treatment Measures • OP Outcomes for New and Review attendances • Patient seen • DNA - Did Not Attend • CNA - Cannot Attend

6. RTT - Whole Journey Measurement From date referral received to date of commencement of definitive treatment Inclusive of: OP attendance + DC/IP procedure

7. 18 week Measure OP Diagnostics IP/DC 18 weeks from referral to treatment for ALL source referrals

8. What we need to measure • Starting point – date referral received • End point – date treatment commenced • One journey

9. Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels there really is another way, if only he could stop bumping for a moment and think of it. “A.A. Milne, Winnie the Pooh

10. 18 week RTT where we are now • Principles and Definitions – Jan’09 • Under review to include Dental, Fitting of Devices, LTC, 1 Stop services, Aesthetic exclusions etc • ‘Frequently Asked Questions’ from T&F Groups • Methodology for Measurement of AP & NAP • Unique Care Pathway Number – from referral • Recording Clinic Outcome Codes July‘09 • Minimum Data Set for onward referrals Jan’10

11. 18WRTT Clinic Outcome Recording • 8 Clock stops codes • Therapeutic treatment commenced • Medical treatment to be prescribed by GP • Patient fitted with medical device • Patient declined treatment • No treatment required / patient discharged • Patient DNA – no further appointment • Return OP appointment – treatment already started /complete

12. 18WRTT Clinic Outcome Recording • 9 Clock still ticking codes • Add to waiting list (including admission today) • Admit today for diagnostic test or test result • Refer for diagnostic test • Refer for treatment to Nurse / AHP • Refer for investigation/ treatment to another clinician same condition & retain responsibility for care • Refer for investigation/ treatment to another clinician same condition & transfer responsibility for care • Return OP appointment - continuing management pre treatment • Patient considering options • Patient DNA – further appointment

13. Benefits • Allows whole journey measurement • Provides rich source of clinical information • Management of onward referrals to other specialties e.g. max fax & plastics • Eases clinical management of referrals • How many referrals were seen & treated at 1st OP • How many referrals were transferred to plastics • How many patients DNA’d with no further appt • etc

14. Long Term Benefits • Opportunity to provide evidence of treatments' in an OP setting • Opportunity to collect OP procedures • Detailed evidence for Consultant work plan • Detailed evidence for accreditation

15. Dermatology Challenges • Clinic outcomes can be locally adapted • Agree locally what you want to collect • 1 referral with >1 reason for referral • How can we manage these?