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Exception reporting for access indicator now launched

by Rima Evans
8 January 2024

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Exception reporting for the Investment and Impact Fund (IIF) indicator that financially rewards practices offering patients an appointment within two weeks is now live.

However, it won’t change calculations for this financial year, NHS England has indicated.

In an update published at the end of December, NHS England said exception flags are now active in both EMIS and TPP practice systems. They can be used to indicate when an appointment is booked more than two weeks in advance for ‘appropriate’ reasons such as patient preference or because of clinical advice.

Cegedim users will see similar functionality being launched in early 2024, according to NHS England’s primary care bulletin.

The new exception categories affect the access indicator ACC–08, which is part of the IIF worth a total of £59m to PCNs.  A maximum of 71 points can be attained by practices and PCNs if they meet a target of 90% of number of appointments being given in two weeks or less, in eight different appointment categories.

Plans to introduce exception reporting around appointments had been announced in NHS England guidance published in April. It had acknowledged that ‘there are good reasons why an appointment may not take place within 2 weeks’, but not being able to report them could potentially negatively affect PCN’s achievement in this indicator, leading to missed income.

Practices are now being encouraged to use the exception flagging functionality ‘to support improvements in access to general practice’ and capture more accurate waiting time information.

However, NHS England also said using the flags will ‘not affect the two-week threshold calculation for this financial year’.

Guidance on how to apply exception flags for appropriate appointments can be found in the information section of each clinical system, NHS England added.

Current thresholds for ACC-08, which are set at a ‘relatively modest’ level, reflect the fact there are no exception categories, NHS England has previously explained.

It said that once appointment exception reporting is available in all systems, thresholds will be revised, increasing to 90% for the lower threshold and 98% for the upper threshold.