Contents
Sources |
Glossary Outpatient Waits and Metrics
Term | Meaning |
Admitted Clock Stops | In England, under the NHS Constitution, patients ‘have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible’. The NHS Constitution sets out that patients should wait no longer than 18 weeks from GP referral to treatment. A clock stop is the point that this time period is measure. It can be for various reasons – For treatment when – a) First definitive treatment starts. This could be: i. Treatment provided by an interface service; ii. Treatment provided by a consultant-led service; iii. Therapy or healthcare science intervention provided in secondary care or at an interface service, if this is what the consultant-led or interface service decides is the best way to manage the patient’s disease, condition or injury and avoid further interventions; b) A clinical decision is made and has been communicated to the patient, and subsequently their GP and/or other referring practitioner without undue delay, to add a patient to a transplant list.” Or For “non treatment” when – An RTT clock stops when it is communicated to the patient, and subsequently their GP and/or other referring practitioner without undue delay that: a) It is clinically appropriate to return the patient to primary care for any non-consultant-led treatment in primary care; b) A clinical decision is made to start a period of active monitoring; c) A patient declines treatment having been offered it; d) A clinical decision is made not to treat; e) A patient does not attend their first appointment following the initial referral that started their RTT clock, provided that the provider can demonstrate that the appointment was clearly communicated to the patient . f) A patient does not attend any other appointment and is subsequently discharged back to the care of their GP, provided that: i) the provider can demonstrate that the appointment was clearly communicated to the patient; ii) discharging the patient is not contrary to their best clinical interests; iii) discharging the patient is carried out according to local, publicly available, policies on does not attend. iv) These local policies are clearly defined and specifically protect the clinical interests of vulnerable patients (e.g. children) and are agreed with clinicians, commissioners, patients and other relevant stakeholders. In this instance the clock stops due to a decision to admit the patient. |
Decision to Admit | A record of the event that a clinical decision to admit a patient to a particular Health Care Provider has been made by or on behalf of someone, who has the right of admission |
Difference in Weeks | In this instance this shows the difference in weeks from a referral to a decision to either admit or not to admit |
Elective Referrals | Elective referral means referral by a general medical practitioner, general dental practitioner or optometrist to a health service provider for treatment that is not identified as being immediately required at the time of referral. In this instance this shows referrals compared to waiting list. |
First:FU | This is the first follow up after referral. This chart shows the proportion of the waiting list which has yet to be given a decision to admit or not admit compared to the length of time it takes to gets to that point. |
Follow Up Appointment | This is the first appointment after the initial one following referral. This chart shows number of follow ups after initial appointment . |
Median Weeks | The median is the value in the middle of a data set, meaning that 50% of data points have a value smaller or equal to the median and 50% of data points have a value higher or equal to the median. In this instance it is the middle number of weeks between the date of referral and admission or non-admission as a clock stop. |
NHS Provider | NHS Providers is the membership organisation for NHS acute, ambulance, community and mental health services that treat patients and service users. |
NHS Trust | An NHS Trust is an organisation. An NHS Trust is a legal entity, set up by order of the Secretary of State under section 25 of, and Schedule 4 to, the National Health Service Act 2006, to provide goods and services for the purposes of the health service. A Trust is part of an ICS. |
Non Admitted Clock Stops | In England, under the NHS Constitution, patients ‘have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible’. The NHS Constitution sets out that patients should wait no longer than 18 weeks from GP referral to treatment. A clock stop is the point that this time period is measure. It can be for various reasons –
For treatment when – a) First definitive treatment starts. This could be: i. Treatment provided by an interface service; ii. Treatment provided by a consultant-led service; iii. Therapy or healthcare science intervention provided in secondary care or at an interface service, if this is what the consultant-led or interface service decides is the best way to manage the patient’s disease, condition or injury and avoid further interventions; b) A clinical decision is made and has been communicated to the patient, and subsequently their GP and/or other referring practitioner without undue delay, to add a patient to a transplant list.” Or For “non treatment” when – An RTT clock stops when it is communicated to the patient, and subsequently their GP and/or other referring practitioner without undue delay that: a) It is clinically appropriate to return the patient to primary care for any non consultant-led treatment in primary care; b) A clinical decision is made to start a period of active monitoring; c) A patient declines treatment having been offered it; d) A clinical decision is made not to treat; e) A patient does not attend their first appointment following the initial referral that started their RTT clock, provided that the provider can demonstrate that the appointment was clearly communicated to the patient . f) A patient does not attend any other appointment and is subsequently discharged back to the care of their GP, provided that: i) the provider can demonstrate that the appointment was clearly communicated to the patient; ii) discharging the patient is not contrary to their best clinical interests; iii) discharging the patient is carried out according to local, publicly available, policies on does not attend. iv) These local policies are clearly defined and specifically protect the clinical interests of vulnerable patients (e.g. children) and are agreed with clinicians, commissioners, patients and other relevant stakeholders. In this instance the clock stops due to a decision not to admit the patient. |
Outpatient | This is where a patient attends a hospital for treatment without staying there overnight. |
Pareto | This is a chart type that are often used to identify areas to focus on first in process improvement. Pareto charts show the ordered frequency counts of values for the different levels of a categorical or nominal variable. The charts are based on the “80/20” rule. |
Ratio of Follow Up to First Appointments | This is the number of appointment after the initial one following referral. This chart shows number of follow ups after initial appointment . |
Referral | Referral means referral by a general medical practitioner, general dental practitioner or optometrist to a health service provider for treatment that is not identified as being immediately required at the time of referred. |
Scatter Plot | This shows the proportion of the waiting list which has yet to be given a decision to admit. Vs how long does it take to get to that point |
Specialities/Specialty | Elective activity is split up into various Specialty codes which denotes which service is responsible for the patient for that element of care. As an example –
General Surgery Urology |
Trend | Trend charts are used to show trends in data over time. |
Waiting List | A list of patients waiting to receive a consultative, assessment, diagnosis, care or treatment activity from an organisation. |