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Planned care is the name the NHS gives to health care services that are arranged in advance, usually following a referral from a GP. It does not cover services and treatment resulting from accident or emergency.

In our planned care programme we have a focus on reducing inefficiencies and unwarranted variation (unwarranted variation is a term used to describe differences that cannot be explained by illness, medical need or what evidence based care). We work in partnership with NHS organisations across Bradford district and Craven and on a wider footprint with organisations across West Yorkshire and Harrogate to develop a more sustainable planned care delivery model. This model aims to address unwarranted variation and inefficiencies across care pathways and will provide people with a guarantee that every referral, outpatient appointment, investigation and intervention will provide maximum clinical value whilst maintaining or improving quality.

Planned care priorities for West Yorkshire and Harrogate

Achievements in 2018/19:

  • implementation of Assist tool for GPs - this tool provides a pathway and referral management add on tool within the existing patient record system
  • review of clinical pathways and improving community services to allow patients to be seen sooner and in the most appropriate setting
  • working more collaboratively between partner organisations across the local health economy and West Yorkshire and Harrogate to improve efficiencies
  • implementation of NHS England’s guidance on evidence-based interventions to reduce variation of care and eliminate the 'postcode lottery'.

CCG improvement and assessment framework

Star ratings

Referral to treatment pathway - 18 week wait times

1StarSmall

One star - worse than the English average. 8 out of 10 people are seen and treated within 18 weeks, this result falls below the 92% standard.

The NHS Constitution describes how patients should wait no longer than 18 weeks from GP referral to treatment (RTT). The CCG is working with our provider organisations to ensure patients are seen in the most appropriate setting, be that in hospital or a community setting. This will help alleviate pressure points and tackle capacity issues. Updated clinical pathways will ensure referrals are only made when necessary and appropriate. The Assist tool will enable GPs to find up-to-date pathway guidance more easily.  

Utilisation of the e-referrals service

2starSMALL

Two stars – similar to the English average. 85% of all referrals are made electronically via the e-referrals service.

From October 2018 there has been a national requirement that all GP referrals are made via the e-Referral Service (eRS). In our hospitals all specialities are on the e-Referral Service. We have developed the Assist pathway and referral tool within SystmOne - our GP patient record system -  to help with making electronic referrals as simple as possible for GPs.

Other indicators

Number of consultant led outpatient appointments

During 2017/18 we reduced follow-up outpatient attendances by 6.4%.

Our aim is to reduce unnecessary follow-up appointments in outpatients and this has been helped by increasingly offering other forms of consultation rather than the traditional face-to-face appointment, for example local providers are able to offer web based e-consultations or a follow-up telephone call.

Utilisation of advice and guidance processes

Advice and guidance services are available for all specialties within Bradford Teaching Hospitals Foundation Trust, the trust respond to 4/5 requests within two working days.