Release 5.0 high level content
Expected release date Autumn 2010
R5.0 main changes
 Support for the Appointment Slot Issue (ASI) process
 Support for Alternative Care Pathways
 Improved service search
 Copying clinical terms
R5.0 minor changes
 Referrer telephone contact details
Referrer and registered GP Practice telephone number fields will be
populated (if the data is held on the Spine Directory Service for that
organisation)
 Ability to record contacts on the Missing Referral Letters
enquiry
Ability for service provider users to record details of contact attempts
(with a referring organisation) when chasing up overdue referral letters
 Service Lifecycle Management
Services that are transitioning to closure will not be available for
shortlisting by referrers. Existing Unique Booking Reference Numbers
(UBRN) with the transitioning service on the shortlist will be able to book,
rebook and cancel their appointments
R5.0 minor changes contd.
 Making rebooking comments visible before an appointment is made
Improves visibility of information to support cancelling and rebooking appointments
 Service provider visibility of UBRN after relationship has ended
SP users will be able to see the history of UBRNs they have
previously had a relationship with for 6 months from date
relationship ended via the Patient Enquiry. Advice & Guidance
responses will be available with no time limit
 Removing request option (if appointment selected)
Booking screen will not allow 'request' to be an option if an
appointment slot has been selected
 Enquiry totals
Users performing a search will see a total of results returned and
instructional messages on system enquiries
Support for the Appointment
Slot Issue process
Current Appointment Slot Issue Process

When a Patient phones The Appointments Line (TAL), and is unable to book an
appointment , the patient has the option to choose the Service they wish to
attend. These instances are known as Appointment Slot Issues (ASIs)

ASIs are reported on a TAL report to all Service Provider organisations that
subscribe to the ASI process, via email on a nightly basis

The Service Provider’s responsibility is then to book the patients that appear on
the TAL report into appointment slots, preferably inside Choose and Book, but
we know this is often done outside of Choose and Book

Meanwhile, the patient is advised to wait a set number of days to hear from their
chosen service

The patient is also asked to ignore any reminder letters that they receive
Summary of changes
 New process to enable users to put patient into ASI
 New ASI worklist for Service Providers
 New ASI Appointment Request Letter
 New extract for Department of Health
 New alert for users to check patients details are correct
 Patient Web Application changes
 Plus a couple of changes which will affect all UBRNs
Who can enter UBRNs into the ASI process?
Following users can enter a UBRN into the ASI Process:
 BMS Admin and BMS HCP Proxy (these users will work at an
appointments line organisation)
 Referring Clinician, Referring Clinician Admin, and Referring Admin
 All service provider users processing an onward referred UBRN initiated
from a service they are associated to, for example from a Clinical
Assessment Service
 All service provider users redirecting an inbound UBRN (i.e. via the
change service functionality)
 Patient (via Patient Web Application)
Following users cannot:
 All service provider users booking/rebooking an inbound UBRN (i.e. not
via the change service functionality)
When can you enter the ASI Process?
One or both of the following criteria needs to be
met when searching for slots:
 No slots are available at a service (user entered values
on Appointment Search which limits slots do not count)
 Technical slot errors occur when the user tries to book an
appointment, i.e. Patient Administration System (PAS)
doesn’t respond or the slot is unavailable
When can you enter the ASI Process?
 Users can only enter UBRNs into the ASI process at
services which experienced a slot issue
 For example, if a service has available slots available to the
user (ignoring user entered restrictions) the user cannot
enter the ASI process at that service
 An ASI cannot be initiated when the patient cannot find
suitable slots
New appointment search screen
New Defer
to Provider
button
Fig X. Appointment Search Screen
Add Defer to provider alert
New
information
message
Summary of short listed
services showing which
services may be deferred to
Select
one
Fig X. Deferral Options Details Screen
Messages
for User
and patient
to note.
View history
action
showing
Deferred to
provider
status of
UBRN
New
provider
ASI
worklist
Actions available from the Provider ASI
worklist
 Book Appointment
 Slot protection and slot reservation functions will be available to the
service provider users to book ASI patients into
 Cancel Request
 Record ASI Contact
 Add/Manage Additional Requirements
 View Request
 View History
Note: As with current functionality, providers will still not be able to access the
referral letter information until an appointment is booked.
Actions available from the Provider ASI
worklist
 New column on Service Provider Appointments for Booking
and ASI worklists:
 ‘Referral First Booked/ASI’
 Shows date of any initial/previous action against the UBRN
(this may indicate an earlier waiting time start date)
 Can be compared with date in ‘UBRN received’ column
New column on Appointments
for Booking worklist
Column
placement on
ASI worklist
Example of
new
Appointment
Request if
referrer puts
patient into
ASI process
Date value calculation
 The contact by date will be ‘X’ number of days from the date a patient’s
chosen service is selected (i.e. the date when the UBRN appears on
the Service Provider Appointment Slot Issues worklist)
 ‘X’ number of days refers to the Priority of the UBRN based on the
following defaulted values:
 2 working days for 2WW referrals
 5 working days for Urgent referrals
 10 working days for Routine referrals
 For example, for a 2WW referral, if the UBRN appears on the ASI
worklist on Thursday 14th January (i.e. day 0), the patient should be
contacted by Monday 18th January (i.e. day 2). This date will be printed
on the letter. Day 3 the entry on the worklist will turn red
Reminder Letter Suspension
While a UBRN is in the ASI process,
reminder letters will be suspended
‘Deferred to Provider’ status
 The status of ‘Deferred to Provider’ will be added to the
following worklists:
 Patient Activity List – in the Category column
 Awaiting Booking/Acceptance worklist – in the Referral Status
column
 Two Week Wait Enquiry – in the Status column
 Appointments for Booking worklist – in the Reason column
 Outbound Referrals worklist– in the Referral Status column
 Patient Enquiry – in the Referral Status column
 Appointments Enquiry – in the Referral Status column
New Department of Health extract
 Slot problems detected in slot searching sessions will be recorded on a
new daily extract as they occur
 A booking outcome will be recorded against each slot issue when the
booking process is completed or abandoned
 The extract will be a .csv file which will be sent to the Department of
Health, and will include the following:







User
UBRN
Slot Issue Reason (no slots, slot unavailable, system unavailable)
Booking Outcome
Service ID and name
Service provider org
Specialty, Named clinician
Reporting changes
 EBSX02, EBSX03, EBSX03a will record the ‘Defer to
Provider’ and ‘Record ASI contact’ actions
 SPR11 (Service Activity) report will have a new column –
ASI – which counts when patient choice is recorded
Patient Web Application changes
 New screens for the patient to enter the ASI process
 New error screens
 Re-numbering of steps to include the confirmation
screen
New error screen on Patient Web Application
Clinic selection screen on Patient Web Application
Confirmation screen on Patient Web Application
Screen on Patient Web Application if patient tries to book
UBRN again
Changes that will affect all UBRNs
 New ‘Check Patient Details’ dialogue
 The dialogue will only appear once for a UBRN within a given slot
searching session
 For users accessing the Deferral Options Details screen, the
dialogue will only be displayed if the dialogue has not already been
displayed in that slot searching session
 Named Clinician displayed on Appointment
Search screen
New alert for ALL UBRNs
Result of
using Named
Clinician filter
in the Service
Search screen
Importance of Change
 Enables bookings to be kept within Choose and Book
 Improved patient and referrer experience
 Reduced time and effort to manage ASIs by providers
 Reduces potential delays to care
Support for Alternative Care
Pathways
Current process
Commissioner is able to restrict access to
Primary Care menu services by
commissioning them as not available for
initial referral. The service is only visible as
an onward referral
Specified Change - Service Definition
Changes:
 Introduces the capability to make Primary Care
Menu and Secondary Care Menu services
restricted (i.e. unavailable for initial referral) for
clinical reasons, or to support Practice Based
Commissioning
 Enables the provider of a restricted service to
specify which services and individual clinicians or
organisations may refer on to, redirect to and
refer directly to their restricted service (authorised
services, organisations and referrers)
Prior Assessment Model
Key
Newtown Hospital
Orthotic
Service
Newtown
Musculoskeletal
Assessment
Service
Village Hospital
Podiatric Surgeon
Service
Newtown Community
Physiotherapy
Service
Restricted
Service
Authorised
Service
Authorised
Referrer
Under local commissioning
The
pathway is Newtown
via the
arrangements,
Newtown
MSK Assessment
Hospital provide
an Orthotic
Service.
This
service
is an a
Service and Village Hospital
authorised
service. Service
Referrals
specialised Podiatric
received
into this
service are
with Surgical
Input.
triaged and/or treated. Those
referrals
clinically
Newtownthat
PCTare
provide
a
appropriate
can
be
referred
on
community Physiotherapy
to
the relevant authorised
service.
service.
These services are restricted
GPs
wishing
to send
referrals to
and do
not accept
referrals
the
restricted
direct
from GPs.services will be
directed to refer via the
authorised service.
Tertiary/Restricted Secondary Care Service
Model
Newtown Optical
Assessment
Service
Village General
Eye Clinic
Liverpool General
Optical Clinic
London Optical
Assessment
Centre
Birmingham
General Eye Clinic
Bristol Eye Clinic
National
Eye
Removal Service
National
Optic
Nerve Laser
Surgery Service
Key
Restricted
Service
Authorised
Service
Authorised
Referrer
The National Eye
Infirmary offers
specialised tertiary
services. These services
are published on the
national DOS as
restricted services. The
DOS entry lists all
available authorised
services that referrers
can initially refer into.
Clinicians within the
authorised service are
able to refer on to the
restricted services
where clinically
appropriate
Specified Change – Initial Referral
Changes:
 Enables initial referrers to see restricted
services and show them a pathway towards
these services
 Allows authorised individual referrers to
refer directly to restricted services
Initial Referral (authorised referrers)
Key
Restricted
Service
Authorised
Service
Authorised
Referrer
Newtown PCT Optical
Assessment
Service
Dr Smith from Newtown Surgery
wants his patient to go to the
National Eye Removal Service.
He is not an authorised referrer so
he cannot make a direct referral to
the National Eye Removal Service.
The Authorised Services presented as
his pathways are Newtown PCT
Optical Assessment Service or
Newtown Hospital General Eye Clinic
and Village Hospital General Optical
Clinic
Newtown Hospital
General
Eye Clinic
Village Hospital
General
Optical Clinic
Dr Jones
Village
Community
Health Centre
Dr Jones from Village Community
Health Centre wants his patient to go
to the National Eye Removal Service.
Dr Jones is a GPwSI and is an
authorised referrer so he can make
a direct referral to the National Eye
Removal Service.
National
Eye
Removal Service
Dr Browne
Newtown
Community
Health Centre
Mr Green
Garden
War Memorial
Hospital
Practice Based Commissioning model
(authorised organisations)
Newtown
Group
Practice
Newtown
Surgery
Newtown PBC
Non-scalpel
Vasectomy Service
Dr Sweeting
& Partners
Key
Restricted
Service
Authorised
Service
The service is defined as a
Newtown Practice Based
restricted service. This particular
Commissioning Group provide a
service has no individual
non-scalpel Vasectomy Service
authorised referrers, and it is an
for all practices within the PBC
initial referral service so there are
Group. The service is not
no authorised services. Instead it
available to other practices within
is restricted to authorised
the PCT
organisations. In this case all of
the practices within the PBC
Group are authorised
organisations.
Fourways
Surgery
Beech Grove
Practice
Village Health
Centre
New Lane
Surgery
Authorised
Organisation
Village Road
Surgery
Two Towns
Group
Practice
Specified Change – Providing Information
Changes:
 Provide new information about restricted services
and why/how frequently they are restricted
 Enhance extract EBSX05 and extract EBSX05a,
to include information about restricted services
 Enhance report COR05 and enquiry SPE08 to
include information about restricted services
 Provide new information about unpublished
services
Importance of Change
 The true definition of a clinical assessment service will
be supported; i.e. only services providing the additional
level of qualification and knowledge necessary to refer
a patient on to a specialised (i.e. restricted) service will
be able to do so
 The current secondary care work-around (where
services are labelled XXX HOSPITAL DO NOT USE
and individual referrers are expected to observe this)
will not be needed and the Directory of Services can be
tidied up
Importance of Change
 The changes will give the capability for multiple
practices who are in the same practice based
commissioning (PBC) group to refer into a specific
service to which other referrers cannot refer
 Initial referrers will be able to place their patient on
the pathway towards the appropriate tertiary service
 Visibility of restricted services will enable users to
challenge any restriction they believe to be for nonclinical reasons
Importance of Change
 Tertiary referrals will be supported i.e. the onward
referral or redirection of a patient from a secondary
care service to a more specialist service
 Service providers will be able to publicise their
restricted services by putting them on Choose and
Book as they will be visible to Choose and Book
users
Improved Service Search
Key points
 Simpler search screen, more intuitive and logical flow
following feedback post Release 4.2
 Improved service search functionality, introduces new
capability to refine service search, e.g. IWT, place,
location
 Removal of redundant search criteria
 The following service search will no longer be
presented to the user on the Service Search Criteria
screen:
Due by Date; Problem; Problem Status; Requested
Procedure
New Service Search screen
Copying Clinical Terms
Key points
 Enables copying of clinical terms from one service to
another
 The two services (copied from and copied to) may be
provided by the same organisation or by different
organisations
Detailed slide pack and training materials will
be available soon, please watch the Choose
and Book website:
www.chooseandbook.nhs.uk/staff/futurereleases/r5.0