Protocols for cancelling medical appointments (FOI)

Request

Recently a deaf friend of mine had an outpatients appointment at Overdale cancelled at the last minute, and was not informed until she arrived. (It was too late for any notice by post). She asked if she could be alerted by text message or email as it is impossible for her to hear over the telephone, but was told that they couldn’t do text message or email, only telephone, which is of course no use whatsoever.

Without wishing for comment on individual cases, and using this only by way of illustration, are there procedures in place for contact to be made by text message or email in these circumstances? Obviously SignVideo while in place, would not be possible without first contacting a deaf person by other means to tell them it was available.

Please can you tell me the protocols for contact at short notice regarding cancellation given that telephone is not an option, and bearing in mind the Discrimination (Jersey) Law 2013, which has hearing loss as a protected characteristic (schedule 1, section 8), and for which there should be avoidance of direct discrimination (Section 6 (1)) or indirect discrimination (Section 7(1))?

If text messaging or email is possible, do staff receive certified training (CPD) on the use in these circumstances where someone is deaf and cannot use a telephone?

If protocols do not exist, please can you tell me when they will be in order to ensure compliance with the Discrimination (Jersey) Law 2013?

Response

If an appointment is cancelled or changed a notification letter will be sent to patients.

If this is at short notice a text message goes out to patients three days before.

If there is a change of shorter notice a telephone call is made.

If an email is requested this is perfectly acceptable and would be encouraged as an alternative in a case such as this.

Staff are given general training on all processes including updating patient details, including any contact details or preference, when they check-in for their appointments at the reception desk. If a person is hard of hearing our TrakCare computerised patient administration system has the function to add an alert, which is added to the demographic screen; this will then automatically pop up to alert the staff.

There are clinics that run independently by manual diary at Overdale, which would not have the alert facility or text messaging facility but a manual process may be in place with contact information and notes against patient records.

A generic email inbox has recently been set up for the patients who cannot contact us by telephone, or have a preference for email, to inform outpatients appointment team of appointment changes / cancellations and vice-versa. This is now available to be included in our form of contact and working closely with our PALS Patient Advisory Liaison Service, this has been set up for communication to the Public. The PALS team also have a generic inbox for patient assistance, which can be provided as a form of contact. (Patients should be aware that any information included in these emails is not a dedicated patient portal but a general email address)

As this information received in this request does not indicate the clinic in question at Overdale, information has been provided for the following clinics:-

• Non-clinical Support Outpatients Appointments Department

• Diabetes

• Pain Clinic

• Neurology

• Urology

• General Medicine

• Retinal Screening

Other clinical areas at Overdale include the following areas:

Older Adult Community Mental Health Services

It is possible to provide notification of a cancellation or change of appoint via email or by a telephone call. At this time it is not possible to provide a notification via text message.

Memory Assessment Service

It is possible to provide notification of a cancellation or change of appoint via email or by a telephone call. At this time it is not possible to provide a notification via text message,

Physiotherapy

If a patient has specifically asked for a type of communication this would need to be added as an alert in the system.

The alert would come up when staff went through the clinic list to cancel appointments, therefore if a patient has requested not to receive phone calls but be contacted by email, we would follow that guidance.

At this time it is not possible to provide a notification via text message.

Dietetics (Adult and Paediatric)

If an appointment is cancelled of change a letter is sent out to the patient.

If there is only a short period of notice a telephone call is made / or if more appropriate an email is sent to the patient.

All staff are given general training on all processes including updating patient details, including any contact details or preference, when they check-in for their appointments at the reception desk. If a person is hard of hearing our Trak Care computerised patient administration system has the function to add an alert, which is added to the demographic screen; this will then automatically pop up to alert the staff.

A generic email inbox is available for patients who cannot contact us by telephone, or have a preference for email, to inform of any changes to appointments and / or prescription requests.

The Patient Advice and Liaison Service (PALS) team also have a generic inbox for patient assistance, which can be provided as a form of contact (patients should be aware that any information included in these emails is not a dedicated patient portal but a general email address).

Speech and Language Therapy - Adults

The service will write a letter, telephone or email patients directly to cancel appointments.

Patients are considered on a case by case because for example, some of them are aphasic or have dementia, so will not be able to read e mails or text messages, or process information over the telephone. There are a whole range of different communication impairments patients may experience the so the most appropriate means of communicating with the individual is identified.

If patients are unable to be contacted directly or the service has prior knowledge of a communication impairment of any sort, and know we cannot reach them through the above means, then the service will we will contacted a named carer or next of kin if consent is given.

Paediatric Speech and Language Therapy

If the appointment is cancelled with more than two weeks’ notice a change of appointment letter is sent to the family.

If the appointment is cancelled within two weeks, then a phone call is made by either the Speech and Language Therapy Administrator to the parents. If no contact can be made then the Speech and language Therapy department will do its upmost to

contact the parents either via email, letter (if within a week of the appointment) or a message to either school, nursery or ward to let the family know (unless parent permission to liaise with school or nursery is not gained).

If the cancellation is immediate eg through therapist illness and an alternative therapist is unavailable to provide cover a telephone call and email is sent to the parents directly to apologise for any inconvenience.

Occupational Therapy (Adults and Paediatrics)

Occupational therapy appointments will be cancelled by the therapist booked to see the client or by a colleague within the department.

Cancellations of a week or more in advance will be by way of a letter.

Cancellations of appointments within three days of notice will be by way of a phone call as standard however if required a text or email can be sent.

If a client or their carer cannot be reached by telephone A text or email will be sent.

Audiology

The Audiology Service provides a telephone number 442551; a dedicated email address (audiology@health.gov.je) which is checked each day; a text number (07797 846960 in and out) . The phone is held by the receptionist during working hours “for those who can’t use a telephone”; facsimile number 442637

For a last-minute cancellation the receptionist would cancel the appointment via text when the person cannot use a telephone.

The service can send an urgent text message or email to a Deaf person for another service with prior consent given. For a text message - please phone us on 442551 to make sure it is actioned immediately.