Currently, under a quarter of patients in England recall being offered a choice of hospital for their treatment. Patients have a legal right to choose their provider, and under measures in the elective reform plan, will be offered a wider choice of providers, while the process of booking treatments and appointments will be made ‘as smooth, supportive, and convenient, as possible’.
Planned NHS App upgrades will enable patients requiring non-emergency elective treatment to:
- view and manage appointments at a time and place convenient to them. In 2023-2024, there were eight million missed appointments in elective care.
- choose from a wide range of providers, including in the independent sector.
- book diagnostic tests through the NHS App at convenient locations, such as a Community Diagnostic Centre (CDC) in a local shopping centre.
- Receive test results quickly through the app before choosing the next step – whether a remote consultation or surgery – at a convenient time and location.
As a first step, by March, patients at over 85% of acute Trusts will be able to view appointment information via the NHS App, and contact their treatment provider at their convenience to receive clear information and regular updates – including on how long they are likely to wait for their appointment. Most patients currently receive test results via a phone call from a clinician, or a letter with either the result or instructions to book an appointment to discuss them further, but this can be a significant time after the diagnostics took place. The Department of Health & Social Care says enabling patients to receive test results quickly through the app will help address these ‘inefficiencies in the process.’
The proposals are part of the elective reform plan, Reforming elective care for patients, which sets out how the government and NHS will deliver on its Plan for Change to ‘slash the waiting list and cut waiting times to 18 weeks by the end of this Parliament’.
Health and Social Care Secretary, Wes Streeting, said: “If the wealthy can choose where and when they are treated, then working class patients should be able to as well, and this government will give them that choice.
“Our plan will reform the NHS, so patients are fully informed every step of the way through their care, they are given proper choice to go to a different provider for a shorter wait, and put in control of their own healthcare.”
The Department of Health & Social Care concedes that the NHS ‘currently lags behind in digital communications’, with just 8% of bookings after a referral being made via the NHS App or the Manage Your Referral website. It says the proposals just announced will drive up this figure by making the NHS App and Manage Your Referral site ‘the default route for patients to choose their provider, or decide not to make that choice themselves’.
More widely, the plan establishes minimum standards that patients should expect – ‘giving them more power over decision-making and what they can expect to be able to do’, including:
- Choosing how they receive follow-ups for care, whether this be digitally or in person.
- Receiving a shortlist of providers to choose from, have the option to choose an appointment that suits them, and receive information on how to change their appointment.
- Deciding whether a follow-up appointment is necessary, or whether it is more beneficial to continue recovering at home.
- Being able to contact their provider for any necessary follow-up, rather than being called back at intervals that do not suit their circumstances.
- Getting clear communications that meet their needs throughout their time on the waiting list.
NHS Chief Executive, Amanda Pritchard, said: “NHS staff are providing record levels of elective care, but with too many patients waiting, we know we need to reform further and faster so we can take our progress on the backlog to the next level. That is why as part of the elective reform plan we will fully harness the potential of the NHS App, giving patients more information, choice, and control, over their care, while freeing up the time of our staff so they can work more productively too.”
Work is underway to pilot AI services that identify patients more likely to miss appointments and provide support, such as free transport to those most in need, while ‘accessible and alternative language, and tailored communications’, will be made available, particularly in areas of highest inequalities, ‘to ensure that all patients have the information they need to take control of their care’.