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Financial Improvement Programme: New pre-assessment DNA/OTDC tracker for theatre efficiency

September 12, 2024

As part of our ongoing Financial Improvement Programme (FIP), we will be sharing regular updates on our progress and highlighting key areas of work.

Through the Theatre Efficiency and Productivity Workstream, we’ve developed and implemented a new tracker within the surgical services pre-assessment and booking teams. This tracker monitors patients who Did Not Attend (DNA) their pre-assessment appointment or had an On The Day Cancellation (OTDC). An OTDC occurs when a patient cancels with less than 24 hours’ notice or when a clinic is cancelled for clinical or non-clinical reasons. A DNA, on the other hand, refers to a patient missing their appointment without any prior notice.

The impact of DNAs and OTDCs at pre-assessment includes:

  • Cancelled surgery dates that must be rescheduled
  • Increased waiting times for pre-assessment and surgery appointments
  • Wasted resources, including pre-assessment slots, admin time, and theatre staff time

Introducing the DNA/OTDC tracker will help reduce wasted TCI dates for surgery appointments by:

  • Ensuring DNAs and OTDCs are recorded and visible in real time
  • Facilitating quicker rebooking of pre-assessment appointments before a patient’s target date
  • Allowing more time to schedule alternative patients

Ultimately, the tracker will allow the booking team to rebook patients more efficiently, while collecting valuable data about why patients cancel or miss appointments. This will lead to improved theatre productivity, allowing more patients to be scheduled for surgery, reducing lost surgical time, and enhancing the patient experience. Importantly, it will also contribute to income generation, helping us meet the £44m target for this financial year.

We would like to thank Jenna O’Connor, Natalie Cutmore, Loraine Burrell, and Christine Billingham from the pre-assessment team, as well as Jaron Kooner and Claire Collett from the booking team, along with the Pre-Assessment Task and Finish Group, for their hard work in developing this impactful solution. This is a great example of how a small change can make a big difference.

Progress Tracker:

  • FIP target: £44.1m
  • FIP identified: £31.2m (risk-adjusted)
  • FIP delivered: £9.2m
  • Left to be identified: £3.7m (8 per cent)
  • Left to be delivered: £34.3m (78 per cent)

Do you have some thoughts on how we can improve our productivity? How about some ideas for cost improvement projects? Then we want to hear from you – often people working on the front line have the best ideas and this is your opportunity to have your voice heard. No idea is a bad idea.

You can submit your ideas via this online form: https://www.surveymonkey.com/r/financialimprovement