Hospitals to be held to new ‘standards’ for patient communication

Hospital trusts will be held to account on eight new ‘minimum standards’ for patient communication, including informing patients within 28 days if their GP referral has been accepted.

Once the referral has been accepted, the hospital must also give patients information to help them while they wait, alongside regular updates on their wait at least every 12 weeks.

If standards are not met patients should contact the patient advice and liaison service at the hospital in question, the new NHS England guidance said.

According to NHS England, the standards will reduce ‘anxiety’ for patients caused by the ‘silence after referral’. 

The first of the eight standards tells patients they ‘will know within 28 days whether your referral has been accepted or what the next steps are’. 

‘Within 28 days of your referral being made you will receive confirmation of next steps in your care. This will often be shown in the NHS App, but it may also be sent by text, post or other methods. 

‘In many cases, you will get confirmation much sooner than 28 days. The 28-day standard is the latest point by which you should be told what is happening next. … If your referral does not lead to you being placed on a waiting list, the provider will explain why and set out the next steps. If a follow-up is needed, your GP practice may reach out to arrange an appointment.’ 

All NHS trusts must publish an annual summary of their performance towards each of the standards to ‘ensure transparency for patients and the public about how their local services are performing’, the document added. 

In a letter to trusts and England regions sent 3 July, NHSE chief executive Sir Jim Mackey said ‘too many patients still don’t feel informed or involved while they wait for their appointments’.

He added: ‘Patients waiting for elective care have too often been left in the dark, not knowing if a referral has been accepted or if they are still on the waiting list.  

‘Some only hear about an appointment after it has already happened. This is entirely unsatisfactory and, if we are serious about improving patient experience of and satisfaction with the NHS, we have to fix the basics – and that starts with how we treat people from first contact and throughout their journey.’ 

At last months NHS Expo conference, Sir Jim said the standards would address the ‘divide’ between primary and secondary care which he said is detrimental to patient experience. 

GP leaders welcomed the new guidance, however with the caveat that they are not stringent enough.

DAUK GP co-lead Dr Steve Taylor told Pulse: ‘These minimum standards are a step in the right direction. Patients are currently left in the dark about the referral process and where they are on the journey to seeing a specialist or waiting for an investigation. This should save some time for GP practices.

‘They don’t go far enough. Hospitals have to make a decision on Single Point of Access requests in 2-5 days, so there is no reason patients need to wait 28 days to inform the patient. Having a message in 12 weeks again leaves a long wait. It’s more important to have indicative times of waits and messages to update you on your indicative time. Waiting 28 days for a new date following a cancellation also seems a long time. It’s progress in terms of information but doesn’t go far enough.’

Professor Azeem Majeed, head of the department of Primary Care and Public Health at Imperial College London, said: ‘The new NHS England communication standards aim to improve the patient experience by ensuring hospitals keep patients informed throughout their referral and waiting-list journey.

‘This should reduce the number of patients contacting their GP to ask about the status of a referral and reinforce that, once a referral has been accepted, responsibility for ongoing communication lies with the hospital rather than general practice.

‘However, these benefits will depend on consistent implementation. If trusts fail to meet the standards, many patients will continue to turn to their GP for help, potentially increasing workload in primary care.

‘General practices will also continue to review patients whose condition changes while they are waiting for hospital care. Robust hospital administrative systems, clear communication and equitable access for patients who cannot use digital services will therefore be essential if these standards are to deliver their intended benefits.’