Mapping appointment slots to the National Standard

Mapping appointment slots to the National Standard

As part of the 2021/22 Network Contract DES, Practices in England are required to map their appointment slot types to a national standard. NHS Digital published a set of national slot categories in 2020, and EMIS released a feature as part of version 9.8 to allow Practices to complete the work.

The work was originally introduced under the GP Appointments Data programme, which became defined as the Appointment Categorisation Standards. It is intended to facilitate the analysis of appointment uptake nationally. For a long time it has been understood at General Practice level that comparing slots and appointment books - even between neighbouring surgeries - is very difficult, and the first version of the General Practice Workload Tool demonstrated how the use of slots can significantly affect the way appointment uptake is interpreted. Fortunately GP surgeries have not been forced to operate their appointment books in a nationally defined way, and the mapping of slot types to pre-defined descriptions allows NHS Digital to continue gathering appointment data and start to produce some meaningful comparisons.

There are a total of 26 slot categories, broken down into three distinct groups of direct patient care, care related activity (clinical admin), and Practice admin. 
Reviewing the categories you might be forgiven for thinking that GPs are expected to account for every minute of their working day, and indeed some Practices may already do this. Wider adoption of this approach would highlight all the unaccounted hours that General Practice staff work, but may make staff feel under scrutiny.
Another consideration for those Practices who are part of a PCN is how the data might one day be used to analyse the true use of Additional Roles staff in a surgery; would underuse lead to a drop in funding perhaps?

Service Setting
This is a simple decision: is the primary function of the slot for General Practice, PCN, Extended Access, or another purpose?
The majority of your slots are likely to be General Practice, while slot types dedicated to PCN staff and Extended Access provisions should be marked accordingly.
Other might be for a third party who uses a room and the appointment book helps reception manage arrivals; community midwife clinics or separately commissioned services may fall under here.

Context Type
With only three choices , this should also be a fairly straightforward selection. Your choice here will determine which group of slot categories are available to pick in the third dropdown.
  1. Care Related Activity - for admin work relating to patient care, this might be used on protected time (and reminders!) for signing scripts, reviewing letters etc. Technically these appointments are not supposed to be bookable.
  2. Care Related Encounter - for appointments, whether they are face to face, telephone, video, or home visits.
  3. Administration and Practice Staff Activities - for non clinical activity. Tea & lunch break slots will appear here, plus meetings, trainee debrief and mentor time, and protected time for regular checks such as stock checking in the treatment room, and inspecting the crash trolley. These slots must be non-bookable.
The work can be completed by a user with appropriate access to the organisation appointments configuration. Users should have RBAC B8017 (Local System Configuration) on their profile or smartcard.
Reviewing slot types is a useful housekeeping exercise which can be undertaken at the same time. Appointment slot reports can be run to assess which slot types are no longer being used and can be archived. We recommend that this work is undertaken by at least two members of staff who understand the appointment system.

Editing slot type properties can cause significant changes to behaviour in the appointment book, and changes should be shared with everybody in the team.

Mapping new Slot Types

After EMIS Web v9.8, adding a new slot type required national slot categories to be set before saving. The screenshot shows the mandatory fields at the bottom with the drop down boxes.

Mapping existing Slot Types

Slots which existed before the National Slot Mapping feature was introduced need to be mapped as a one-time exercise. Primary Care IT delivered a webinar (36 mins) to support the mapping exercise.

It is recommended for Practices to familiarise themselves with the guidance before completing the mapping exercise, and use it as reference when creating new slots in the future.

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