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Exception reporting for access IIF indicator still being planned

by Rima Evans
13 November 2023

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Efforts to introduce exception categories within the IIF indicator on patient appointments are ongoing, NHS England has reiterated in new guidance.

A document, published last week, aimed at helping practices and PCNs improve accuracy of recording appointment data, said NHS England (NHSE) is currently working with IT suppliers to implement a new system of exception reporting that would affect indicator ACC-08.

This indicator, part of the Investment and Impact Fund (IIF), which in total is worth £59m to PCNs, financially rewards practices and PCNs offering patients an appointment witin two weeks or less. A maximum of 71 points can be attained.

NHSE has been clear that there will be good reasons for why some appointments aren’t given within the two week target and that it’s not expected all would. ‘There will be cases where due to patient preference, or clinical advice, the period is longer,’ its guidance said. ‘NHS England is working with IT system suppliers to implement exception categories reflecting this.’

For now, thresholds have been adjusted to reflect the fact there are no exception categories, NHSE further explained.

These thresholds are set a ‘relatively modest’ level, according to NHSE. The lower threshold of 85% corresponds to the 20th percentile of current national performance, while the upper threshold of 90% corresponds to the 50th percentile (median performance). So, to earn all available points PCN need to be performing at the current median.

Meanwhile, NHSE set out a number of points for practices and PCNs to improve the quality of GP appointment data (GPAD) reporting.

This is important, it says, to get a better understanding of how appointments are planned and managed locally but also because practices and PCNs attract payment for improving their appointment recording via the Local Capacity and Access Improvement Payment (CAIP)and the IIF indicator A008.

Key topics it covers in more detail are on category, service setting and mode, which are the main areas for achieving accurate reporting, it said.

The guide highlights that there is new functionality to help record the mode of appointment (its format such as being face-to-face or telephone, for example) to make it more standardised .

 And it lists the steps users now need to take when recording the mode of appointment.

The guide also links to a central repository for GP appointments data (GPAD), a hub with more information and polices created to support GP practices, PCNs and integrated care boards (ICBs) enhance ‘the quality of their data, so it more precisely reflects the services they provide’.