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    Articles > A 5-step process on how to reduce unnecessary outpatient appointments with Four Eyes Insight.

A 5-step process on how to reduce unnecessary outpatient appointments with Four Eyes Insight.

‘The time has come to re-evaluate the purpose of outpatient care and align those objectives with modern-day living and expectations.’ NHS England Medical Director, Professor Stephen Powis.

In 2018, The Royal College of Physicians article, Outpatients: the future stated the NHS receives over 118 million outpatient appointments every year – many of them are unnecessary. In 2022 that number continues to rise, with the demand for hospital treatment exceeding capacity before COVID-19, it comes as no surprise that the need to deliver care during a pandemic has led to significant backlogs and longer waits for patients.

Moving forward, a recent article published by the NHS, Outpatient Model suggests ‘we must focus capacity on those with the most urgent needs and those who have been waiting a long time for care, making the best use of valuable staff time and resources. With this, each provider has been asked to reduce outpatient follow-up appointments by a minimum of 25% by March 2023 – going further where possible, to re-allocate time to prioritise activities to support elective recovery.

As operational productivity experts, with extensive clinical experience, our process is designed to seek out long-term value for patients, the population and the environment – transforming the performance of our health service with measurable and sustainable results, not just ahead of March 2023 but for the future.

It’s our mission to implement interventions that optimise elective care pathways and provide tools to monitor their effectiveness, ensuring that a culture of continuous improvement to drive long-term, sustainable change is embedded along the way.

To achieve a sustained reduction in unnecessary outpatients requires a core operation for good practices as a foundation for broader change. Using our framework, we aim to support your team with the tools needed to reduce those unnecessary appointments, backlogs and increase efficiency with measurable results.

Here’s how:

Data-Driven Analysis

The first step in our process is to undertake a deep dive into your data to assess your current situation. This includes undergoing an in-depth analysis using our Business Intelligence (BI) model to identify problem areas as well as opportunities to increase productivity and efficiency with immediate effect. Our recommendations are always validated by our expert team of consultants who work together with your team on the ground.

The BI analysis is followed by optimised scheduling, which looks at performance at a macro and micro level. We can get as granular as assessing the productivity of a particular clinic code, or a particular clinician within the team and identifying areas of opportunities within their specific field.

Let’s begin the Implementation

Following the completion of our analysis, we would report the findings and discuss our implementation phase, which is managed by our experienced clinical and operational delivery leads working hands-on with staff to share their knowledge and expertise.

In order to build bespoke patient pathways and devise a business plan model to reduce those unnecessary appointments and did not attend (DNA), our team would design bespoke services for your particular needs. At Four Eyes Insight we aim to target and tackle any operational issues and blockers preventing required productivity improvements.

We do this by, implementing a structured Patient-Initiated Follow-up PIFU plan for patients with long or short-term conditions in a broad range of specialties. This plan enables the patients and their carers to get the flexibility to arrange their follow-up appointments as and when they need them – with the incentive to empower patients and their carers to manage their own decisions in line with the NHS personalised care agenda; driving down unnecessary follow-up appointments.

In addition to this, a crucial pillar outlined in the Principles and approach to delivering a personalised outpatient model is to deliver a personalised outpatient model that better meets the individual patient needs and improves the quality of care and patient outcomes.

Here we would look to develop your analytics, through a clinical review and validation of OPFU waiting lists, supporting your team with re-purposing clinical time from appointments that were clinically beneficial to do so.

Not forgetting the additional areas we would look to optimise, including, increasing utilisation and throughput the reduction of DNA’s as well as coordinating diagnostic test results to streamline pathways and minimise appointment cancellations.

Time to Change

It is important to adopt a robust change management strategy to understand the impact of immediate wins agreed upon during the analysis. Practical tools and techniques deployed using our BI model will begin to shape and change the future of reporting on your team’s efficiency. This approach helps to provide a pace and strengthen operational grip with the overall aim to improve appointments and eradicate unnecessary ones.

The speed of our programmes is designed to maximise the annual effect and establish efficient and robust changes to the current process – with clinical and administrative teams working collaboratively to provide direction and focus.

Monitor the results

Following the implementation process, we will continue to offer arms-length support through remote monitoring of performance.

Our team of experts will monitor and support using Four Eyes Insight’s ‘in-session’ productivity approach, to highlight performance and progress, benchmarking this against the established efficiency improvement targets, resulting in your team being able to see month-on-month a reduction in unnecessary appointments.

Using Four Eyes Insight’s proven processes and applications will help to translate the significant efficiencies which will translate into a sustainable reality.

Sustainable Change

Our main focus, working in line with a Greener NHS  is to create technology-led data processes which lead to sustainable changes that last. Whether it’s through our custom-designed capacity management solutions or a light touch continuous service. Four Eyes Insight strives to provide continued support for operational improvements and help your team with reducing unnecessary outpatient appointments in the future.

Interested in hearing more?

At Four Eyes Insight, we have seen first-hand the power that our work has had on improving elective recovery. We do this by the combined the power of people, data and technology to get to the root cause of NHS elective care pathway inefficiencies; working collaboratively and engaging with all stakeholders to get buy-in for change from the ground up. If you would like to find out more or discuss your requirements, please email