Waiting List Validation
Validation is determining the status of a patient through a clerical review of the available patient information, and then taking the next clerical action.
The next clerical action could be:
Discharging the patient - for example, if the consultant has stated in a clinic letter that the patient is to be discharged to the GP, or if the patient has DNA'd twice, meeting the Trusts criteria for an administrative discharge
Escalating the patient to the Trusts attention – for example where the patient has been found to be at clinical risk, or if a clock start date readjustment will lead to a 104-week breach
Moving the patient to the correct waiting list – for example, applying a clock stop to remove the patient from the RTT PTL and ensuring the patient is now on the Non-RTT (follow-up) waiting list
Making a correction so that the pathway is an accurate reflection of the patient journey - for example, amending an RTT code from a 30 (first definitive treatment provided) to a 34 (decision not to treat) if the original code was applied incorrectly
There are many uses for validation, but typically validation programmes of work will fall into the following categories:
Removing pathways inflating the RTT PTL that should not be included in RTT reporting:
Discharges – Where the patient has been discharged but remains on the RTT PTL.
Non-RTT - pathways that remain on the RTT PTL after the patient has received first definitive treatment or has been placed on active monitoring.
RTT exclusions - active pathways that have yet to be discharged or receive first definitive treatment, but are not subject to RTT reporting e.g., it is a non-consultant-led service.
Duplicates – Where multiple instances of the same pathway are present on the PTL.
Non-RTT (Follow-Up) validation
Removing unnecessary activity from the waiting list where the activity is no longer required. This is typically because the activity has already taken place but the appointment request was not closed down upon outcoming the appointment, or where there is no longer clinical value in the appointment taking place
Escalating patients that are found to be at risk of clinical harm, for example, if a patient has been found to be ‘lost to follow-up’.
Identifying patients that are appropriate for being placed on a PIFU (patient-initiated follow-up) pathway.
Diagnostic waiting list validation
Determining whether the patient has had the diagnostic undertaken, whether the report has been conducted, whether the patient requires subsequent care and which waiting list they should be on (RTT or Non-RTT).
Data quality validation
Where the Trust is aware of a data quality issue and needs to determine the status of a group of patients, for example, a large volume of referrals that remain open where the Trust needs to confirm the patient journey has been or is being managed appropriately.
Migration support validation
When a Trust is transferring from one EPR/PAS to another, ensuring that only the appropriate records have been migrated, and performing any post-migration data corrections if any unexpected issues arise resulting from the migration.
Cancer waiting list validation
Ensuring that the Trusts cancer patients’ journey is being managed appropriately and that the Trust position against the cancer waiting times standards is accurate.
Trusts provided with validation support
NHSEI national validation programmes delivered
NHS Trusts provided with RTT training
PAS systems utilised when validating
The most accomplished of validation to the NHS
“I would highly recommend Source Group to any Trust looking to review their waiting lists or seeking assurance on their waiting lists”
Deputy Chief Operating Officer
Liverpool Women’s NHS Foundation Trust