Background The Epilepsy service (ABUHB) ran along a traditional booking model. The follow-up burden was not serviced by fixed capacity. Follow-up appointments over target time were measured at 1023 and typically routine follow-ups were 18 months overdue.
Innovation We implemented a switch to ‘open access’ service(OAS). Stable patients do not need to be automatically booked into a specialist service as they will receive an annual review in primary care(NICE 2012). In contrast, patients experiencing a sudden deterioration in seizure control need rapid intervention. This model requires ESNs provide advice/management changes and if necessary, book patients into rapid access clinics. Specialist epilepsy management is undertaken by the ESNs with appropriate consultant support.1 This enables patients to access services as and when they need it, rather than at a pre-specified time in the future.
Outcomes At 6 months our current mean wait time for OAS is 13.4 days(d). Prior to OAS, patients deemed to need an expedited epilepsy appointment waited a mean of 52d. A consequence of having unfilled hot slots in our OAS clinic has been a reduction in our TLOC wait time from 66d to 28d.
Summary Individuals with clinical needs are now being seen in a timely manner.