3. Rapid Impact Assessment summary report

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1 Audit Risk Level: Medium (Risk level will be added by EQIA steering group) 3. Rapid Impact Assessment summary report Each of the numbered sections below must be completed Interim report Final report x (Tick as appropriate) 1. Title of plan, policy or strategy being assessed. Patient Reminder Service 2. What will change as a result of this proposal? Patients will receive a courtesy reminder call 7 days before their expected appointment. It is hoped that this reminder will enable fewer Did Not Attend patients (DNAs) for clinics. The patient reminder service is delivered through two systems: Chronos 360 CRM (automated calls plus an agent call after two failed automated attempts, or for certain patient groups such as older people); Netcall Remind Plus (automated calls only with no agent back-up). 3. Briefly describe public involvement in this proposal This and the other work being undertaken in relation to Outpatients was discussed at the St John s Patient Forum on 8 April Evaluations have taken place and feedback gathered to obtain the views of the public. 4. Date of RIA 3 April Who was present at the RIA? Identify facilitator and any partnership representative present Name Job Title Date of RIA training Dawn Associate Carmichael Director of Finance

2 Gemma Couser Shirley Thomson James Glover (Facilitator) Assistant Service Manager Project Coordinator Head of Equality & Diversity Nov Evidence available at the time of the RIA Evidence Available? Comments: what does the evidence tell you? Data on populations in need Yes Data on service uptake/access Yes DNAs have reduced using both reminder systems Data on quality/outcomes Yes One system provides a telephone number cleaning service which has identified and provided corrected contact numbers for circa 20% of patients contacted Research/literature evidence Yes Widely used in the NHS in England and elsewhere in Scotland. Patient experience information Yes Further feedback will be sourced from patients via short telephone questionnaire Consultation and involvement findings Yes Positive feedback received from patients. Received positively by the SJH patient forum. Good practice guidelines Yes Other (please specify) Yes 7. Population groups considered Older people, children and young people Women, men and transgender people (include issues relating to pregnancy and maternity) Disabled people (includes physical disability, learning disability, sensory impairment, long term medical conditions, mental health Potential differential impacts One of the service providers do not undertake automated calls to patients over 65 years of age, rather call is undertaken by an agent. Multi-channel communications. Pilot has indicated that there are potential communication issues using this Service for those who are either visually or hearing

3 problems) Minority ethnic people (includes Gypsy/Travellers, non-english speakers) Refugees & asylum seekers People with different religions or beliefs impaired. Alternative means of reminding this group will be considered if pilot successful and rolled out further. These patients need to be accurately identified as visually/hearing impaired in the patient record. However there is a positive impact in that the reminder is by telephone, so if a patient cannot read appointment letters because of their visual impairment they will at least find out about the appointment verbally. Patients with a cognitive impairment, learning disability or with some mental health problems may find the calls confusing and/or unsettling. The system leaves a telephone number for a named NHS member of staff (Shirley Thomson) so that people who dial 1471 or who call back will reach a real person rather than an answering machine. There may be language issues which mean that a patient or another person picking up the phone may not understand the purpose of the call. Chronos 360 CRM have staff who are able to speak a range of languages. Netcall Remind Plus is fully automated so this is less flexible. As for BME people above. Lesbian, gay, bisexual and heterosexual people People who are unmarried, married or in a civil partnership People living in poverty / people of low income Homeless people People involved in the criminal justice system The systems have made it easier for people to rebook appointments at a time that suits them, enabling patients or carers on low incomes to fit appointments around their work more easily. These patients have been identified as a group that needs to be considered further. Prisoners are currently not told of appointment until day of appointment.

4 People with low literacy/numeracy People in remote, rural and/or island locations Generally, hospital not advised of patients status as a prisoner. The fact that the reminder is via telephone means that people with low literacy who would not understand a letter can find out about their appointment more easily. Carers (including parents, especially lone parents; and elderly carers) Staff (including people with different work patterns e.g. part/full time, short term, job share, seasonal) OTHERS (PLEASE ADD): Changing the way of working on a daily basis, particularly where over-booking has become standard. Clinicians have noted increased workloads due to reduction in DNAs. 8. What positive impacts were identified and which groups will they affect? Impacts Affected populations Improved communications between clinics and patients Improved relationship between patients and staff Positive impact on staff when higher numbers of patients attending appointments Increased quality in healthcare Improved awareness of appointments for patients and their carers who find it hard to read letters Staff/patients Staff/patients Staff All Disabled patients; older patients; patients who have literacy problems; some patients who do not speak English who are contacted by Chronos 360 CRM 9. What negative impacts were identified and which groups will they affect? Impacts Affected populations Confusion where patients or their carers do not understand the calls or are unsettled by them Increase in staff responsibilities Disabled patients and carers, older people, people who do not speak or understand English

5 Increase in numbers of patients attending creating staffing issues in clinics Staff 10. What communications needs were identified? How will they be addressed? Initial communication of this pilot was via press release to all local newspapers, posters and leaflets in pilot areas and included at the bottom of outpatient letters. Recommended that a further communication is undertaken to ensure that staff and patients/carers are kept informed of service. 11. Additional Information and Evidence Required If further evidence is required, please note how it will be gathered. If appropriate, mark this report as interim and submit updated final report once further evidence has been gathered. 12. Recommendations There should be ongoing communications to patients and their families/carers instead of just a one-off campaign, to raise awareness of the scheme among the wider public. The training provided to Chronos 360 CRM agents should be identified and reviewed, particularly in relation to how agents communicate with people who appear to have language or comprehension difficulties. 13. Specific to this RIA only, what actions have been, or will be, undertaken and by when? Please complete: Specific actions (as a result of the RIA) Who will take them forward (name and contact details) Deadline for progressing Review date Develop ongoing communication plans D Carmichael End May 2013 End July 2013 Obtain information from Chronos 360 CRM about how their agents are trained and supported, particularly in dealing with people who do not understand English or who may have cognitive or other impairments which make it hard for them to understand the calls Shirley Thomson End May 2013 End July 2013

6 14. How will you monitor how this policy, plan or strategy affects different groups, including people with protected characteristics? Ongoing audit of the Reminder Service pilot. Manager s Name: Shirley Thomson Date: 18 April 2013 Please send a completed copy of the summary report to: James Glover, Head of Equality and Diversity Note that you will be contacted by a member of NHS Lothian s impact assessment group for quality control and/or monitoring purposes.

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