Cancelled health appointments and waiting lists (FOI)

Request

Would it be possible to find out the number of cancelled health appointments and operations in Jersey over the past three years?

Could you break this down by year and month and also list the type of appointment / operation and the reason why it was cancelled. 

If you could also provide a current breakdown of waiting times for appointments and operations that would be greatly appreciated. 

As well as the target waiting times for each of these (if there are any)?

Response

Table 1 shows the number of cancelled operations by reason per month from January 2019 to December 2021. The table excludes Obstetric and Emergency (CEPOD 1) operations.

Table 1.pdf

These figures have been derived from the digital system data held by Health and Community Services (HCS). Detailed reasons for cancellation may be recorded in individual medical records, but this information is not held centrally. Examining individual records for cancellation details would exceed the timescales prescribed in the Freedom of Information (Costs) (Jersey) Regulations 2014. Therefore, Article 16 of the Freedom of Information (Jersey) Law 2011 has been applied in this respect.

The current patient administration system has functionality limitations that do not allow re-scheduling in all circumstances, leading to inflated cancellation numbers. A new system is due for implementation in 2023.

Numbers in the ‘Cancelled by Admissions Department’ column predominantly relate to re-scheduled operations which are cancelled in the system and a new booking made but may also include cancellations when a patient is deemed to not be medically fit to undergo surgery, reduced bed availability at times of increased service pressures, and administrative errors. Administrative errors include system recording errors which are promptly rectified and do not relate to an actual cancellation of an operation, so do not affect operating slot availability, waiting times or patient care. In these circumstances, patients would not have received notification of the booking. 

It is important to note that when it became necessary to cancel and re-schedule operations due to Covid-19, some of these have been recorded as cancellations in the table below against another reason, or in the ‘Reason Not Recorded’ column. 

Table 2 shows the number of cancelled operations by month and specialty from January 2019 to December 2021. The table excludes Obstetric and Emergency (CEPOD 1) operations.

Table 2.pdf

Table 3 shows cancelled outpatient appointments by cancellation reason. Cancellations denoted under ‘Admin Error’ include system recording errors and clinic changes and may not relate to an actual cancellation of an appointment. 

Table 3.pdf

Please note that data for cancelled Mental Health appointments is shown in separate tables, broken down into Adult Mental Health Services and Child and Adolescent Mental Health Services, as the options to record against reason for cancellation differ.

Table 4 shows cancelled Adult Mental Health Service appointments by cancellation reason. Cancellations denoted under ‘Appointment booked against wrong patient’ and ‘Operator error’ include administration errors which do not relate to an actual cancellation of an appointment. In these circumstances, cancellations do not affect appointment availability, waiting times or patient care and patients would not have received notification of the booking.

Table 4.pdf

Table 5 shows cancelled Child and Adolescent Mental Health Service (CAMHS) appointments. Reason for cancellation is not recorded in the digital record system for these appointments. Detailed reasons for cancellation may be recorded in individual medical records, but this information is not held centrally. Examining individual records for cancellation details would exceed the timescales prescribed in the Freedom of Information (Costs) (Jersey) Regulations 2014. Therefore, Article 16 of the Freedom of Information (Jersey) Law 2011 has been applied in this respect.

Table 5.pdf

Please note that the tables detailing cancelled health appointments display information that is held in the central HCS digital system and may not capture all activity, as not every individual practitioner in all service areas has access to an electronic booking system. Collating information that is not held in central record systems would exceed the timescales prescribed in the Freedom of Information (Costs) (Jersey) Regulations 2014. Therefore, Article 16 of the Freedom of Information (Jersey) Law 2011 has been applied in this respect.

Work is underway to improve data on service activity in Mental Health Services, as detailed in a recent Freedom of Information request relating to Mental Health referrals:

Mental Health data (FOI)

Elective inpatient (planned operations), outpatient and diagnostic test waiting lists are available on www.gov.je at:

Health and Community Services hospital waiting lists (FOI)

As this information is available elsewhere, Article 23 of the Freedom of Information (Jersey) Law 2011 applies.

Referrals are assessed as urgent, soon or routine and prioritised accordingly. Target waiting times vary across services, and target waiting times for outpatient appointments can differ from inpatient bookings within a service. 

Waiting times may be impacted by service pressures, including total number of referrals, number of urgent / soon / routine referrals, resources, and other factors, such as the service restrictions necessitated through the Covid-19 pandemic. 

Articles Applied

Article 16 - A scheduled public authority may refuse to supply information if cost excessive

(1) A scheduled public authority that has been requested to supply information may refuse to supply the information if it estimates that the cost of doing so would exceed an amount determined in the manner prescribed by Regulations. 

Article 23 - Information accessible to applicant by other means

(1) Information is absolutely exempt information if it is reasonably available to the applicant, otherwise than under this Law, whether or not free of charge.

(2) A scheduled public authority that refuses an application for information on this ground must make reasonable efforts to inform the applicant where the applicant may obtain the information.