Appointment punctuality policy

Introduction

On occasion, patients attending appointments at this organisation will be late due to circumstances beyond their control. This document provides direction for the management of patients who fail to attend appointments punctually.

In accordance with the Equality Act 2010, this organisation has considered how provisions within this policy might impact on different groups and individuals. This document and any procedures contained within it are non-contractual, which means they may be modified or withdrawn at any time. They apply to all employees and contractors working for the organisation.

Patient responsibility

The NHS Constitution outlines within the Patient and the public: your responsibilities section what is expected of patients and explains that patients should keep appointments or cancel within reasonable time.

Furthermore, in the NHS England guidance titled You and your general practice (YYGP), there is a contractual mandate for this organisation to ensure that patients are seen within an appropriate timescale. To be able to achieve this, patients must also accept that they have a responsibility, and this is detailed within this guidance where it states that they should be on time or cancel if the appointment is no longer needed.

Sometimes, patients arrive and simply take a seat in the waiting room assuming that there is no need to ‘book in’ upon arrival. To avoid any inconvenience for all, a self-check-in poster is available to remind patients to use the self-check-in screen upon arrival, although this may not be possible should the patient arrive either close to or after the designated appointment time.

Management of late arrivals

To adhere to the appointment schedule and to ensure all patients receive an excellent level of service, late arrivals are to be managed as follows:

• Less than 50% of the way through their appointment (e.g. less than 5 minutes late in a 10-minute appointment) – staff will:
  • Mark the patient as having arrived, advising them that the clinician may already be seeing the next patient
  • Explain that the patient will be seen after the clinician has finished with their current patient
  • If appropriate, remind the patient of the importance of attending appointments on time

More than 50% of the way through their appointment (e.g. more than 5 minutes late in a 10-minute appointment) – staff will advise the patient that they are late for their appointment and offer the following as appropriate:

• Offer the patient an appointment later during that session or that day (if an appointment is available)
• Discuss the patient with the clinician (using instant message) and, if in agreement, and the patient is willing to wait, advise that they will be seen at the end of that session. The patient should be made aware that this may be some time
• Should the above option not be possible, the patient should rebook for another appointment

Self-check-in screens will not allow patients to register their arrival after their appointment time, and will instead display a message advising the patient to check-in at reception.

It should be noted that it is at the discretion of the clinician whether the patient is seen or not; there may be a valid reason for being late and each patient will advise staff accordingly. Ideally, clinicians are to be informed of any late arrivals via a instant message.

Management of waiting patients

Should staff note a patient has been waiting for more than 30 minutes, they should apologise to the patient, explaining the reason(s) for the delay. Sometimes it may be that the patient has forgotten to check-in or that the reception team has failed to book the patient on the system as having arrived. In the case of an administrative error, the administration team should advise the clinician of this and confirm the patient did not arrive late for their appointment. Every effort should then be made to ensure the patient is seen in sequential order rather than being offered a later appointment.

If this situation occurs on a regular basis, management will consider conducting an audit with additional training being a consideration.

Recording of Information

Administrative staff are to annotate the outcome of the discussion with the clinician regarding those patients who are late for an appointment. 

When a patient is late and the appointment is cancelled, then this is classified as a “Did not attend” due to the appointment not being able to be reused.

Clinic lateness

The organisation is fully committed to running to schedule and, should this not be the case, patients will be advised at the earliest opportunity as to the reasons why and the expected duration of the delay. Reasons for delay may be, but are not limited to:

• Medical emergencies
• Complex routine appointments overrunning
• Delay in staff arriving due to external factors beyond their control
• Administrative error by a patient or staff member

In all cases, reception staff must advise patients accordingly.

Occasionally, a patient may suggest that they want to make a complaint following an overrunning clinic. Should they wish to do so, then the organisation’s Complaints Procedure should be referred to.