Client stories
Specific lists, awkward delays, and one review that arrived later than asked.
These notes name the engagement. They are not star ratings. Where a client was impatient with us, that stays in.
Helen sat in our Solihull waiting area on a Tuesday that we already knew ran long. The review did not scold the consultants. It showed that our first slot was a new patient in a follow-up time, and that the room turnaround after dilating drops was never on the template. We changed two lines on the book. Thursdays are still untidy — the review said they would be, until we stop mixing injection lists with routine follow-up.
Priya Nandha · Practice manager, multi-site ophthalmology group, West Midlands · Clinic operations review
We had been reporting an 11% DNA to the board for a year. The study split hospital cancellations out of that figure and we were left with a much smaller true non-attendance, plus a pile of unused slots after 15:30 that nobody was offering to the waiting list. I wish we had asked for the coding note before we printed posters about ‘missing appointments’.
James Okechukwu · Outpatient lead, community MSK clinics, Kent · DNA and unused-slot study
The template study was slower than I wanted. Extracts arrived late from our PAS host, and Portalanchorcore would not pretend the April figures were complete. That delay annoyed me at the time. The eventual paper was the first time a partner meeting looked at punch-biopsy slots as 25 minutes rather than 15.
Ellen Fraser · Partner, dermatology outpatient rooms, Edinburgh-linked group with an English site · Appointment template study
I asked for a pack I could walk through in twenty minutes before the monthly partners’ meeting. I received four pages, a caption on every chart, and a recommendation that named the Thursday hernia list rather than ‘surgical outpatients’ as a whole. Nobody asked me what a utilisation ratio was, because the word did not appear.
David Lang · Clinical director, general surgery outpatients, Northamptonshire · Operations papers for the board
Comparing our three sites had become a sport. Each manager brought a different DNA definition. The comparison forced one set of codes and one twelve-week window. Rochdale still looks worse on start delay; we now know it is the 08:30 list clashing with staff parking, not a mysterious culture problem.
Saima Rahman · Operations lead, three-site outpatient hub, Greater Manchester · Multi-site outpatient comparison
Two longer notes
A one-stop eye list that was three lists in a coat
Clinic operations review
A private outpatient group in the East Midlands asked us to look at a ‘one-stop’ ophthalmology morning that routinely finished after 13:30. The book showed twelve patients. Observation showed a visual-fields machine in a different corridor, dilation in a chair that was also the overflow waiting area, and letters typed after the last patient because the admin hour had been removed from the job plan. The written review kept the one-stop ambition and split the morning into a diagnostics block and a consultation block on alternate weeks. Six months later the group sent a short note: the list now ends near 12:40, and they still dislike the alternate-week pattern, which is a fair complaint and not one we hid in the paper.
Unused afternoon slots in a community dermatology hub
DNA and unused-slot study
A community provider in the South West believed DNA was emptying its Friday afternoon lists. The extract showed something plainer. True DNA was modest. From 14:50 the remaining slots were held for ‘urgent additions’ that rarely arrived after the local minor-injuries unit changed its referral window. Reception had no authority to release those holds on Thursday. The study recommended a noon cut-off and a phone-through to the waiting-list clerk. The group adopted the cut-off and left the phone-through; even that half-measure filled four of six held slots in the first month we were shown.