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How our trust will save up to £150,000 on appointment letters

How our trust will save up to £150,000 on appointment letters
By Sue Elliston
14 November 2018

East Lancashire Hospitals NHS Trust has introduced a digital letter portal that allows patients to receive their appointment letter straight to their phone, cutting appointment letter costs by 51%.

The system will allow the trust to save around £150,000 once it’s been fully rolled out.

Sue Elliston, directorate manager of centralised outpatients and administration services for East Lancashire Hospital NHS Trust explains why the change was implemented.

The problem

We were concerned with our did-not-attend (DNA) rate, which was slightly above the regional average.

In 2016, our DNA was around 9.4% and the regional average was about 9%. In 2017/18, we started looking into how we could improve that rate. We wanted to increase the number of patients attending their outpatient clinics and reduce slot wastage.

The solution

Last summer, we launched an appointment reminder campaign to help us decrease the number of patients missing their appointments.

We introduced a text reminder service that helped us drop our DNA rate from 9.4% to 7.5%. It meant that we had about 10,000 additional appointments available within the organisation, appointments that were no longer wasted.

However, the text reminder service did not help us reach out to the entire community, which in our case is highly diverse. The service is in English, which means it does not support the diversity of our community, where some groups need to have access in a language other than English.

For this reason, we decided to upscale our digital offer in July this year and introduced a digital letter portal, pioneered by Healthcare Communications.

The portal allows patients to view appointment letters, book or cancel an appointment on any device, download an interactive home-to-hospital Google map and have the text translated – with a choice of 99 different languages.

The benefits

We launched the digital letter portal in July and by September around 54% of our patients had opted to receive their appointment letters electronically.

Initially, we introduced the portal to deal with centralised outpatient appointment bookings – managed by a team of about 40 people.

They deal with around 450,000 outpatient appointments a year but sometimes appointments are booked directly within that department, for example if it is a follow-up appointment.

For this reason, from 22 October, we extended the digital portal to cover some specialist outpatient areas such as pre-op assessment, elective admission, therapy and musculoskeletal appointments.

We expect to reach full roll-out, which will include every area within the trust, in the next six to eight months.

According to rough estimations by Healthcare Communications, we will save £100,000 a year and this will rise to £150,000 as we complete the rollout.

Patients don’t want to be in hospital so you need to make the service as straightforward as possible for them, as informative as you can. Once you do that, the savings will follow.

The system also saves our admin team time. We estimate that our centralised team spends roughly 30 hours a week on managing letters, as they need to be printed out, folded, put in an envelope, and posted.

The challenges

The main challenge is making sure you’ve got the electronic process right. You’re dealing with electronic logic, which makes lots of different connections in a very complex thought process.

So you end up with a whole suite of generic letters which are then populated by the information from our patient administration system.

You then have to make sure that you’ve got all the right information condensed into those letters, that the letter is sent to patients in an efficient way, that they’re able to download that information and if not, which safety measures you have in place to make sure the system does work correctly.

I would recommend anyone looking into introducing this system to be brave. It’s complex and difficult, and sometimes you just have to be confident that you’ve done everything that you possibly can.

It’s sometimes necessary to make a change, to do something a bit differently and work through the small number of issues that you get.

Sue Elliston is directorate manager of centralised outpatients and administration services for East Lancashire Hospital NHS Trust


Additional reporting by Valeria Fiore

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