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<pre>
 
 
 

Policy 

Guideline 
Specialist Outpatient Services Patient Focussed 
Bookings Guideline 

 
 

Objective file number: eA524285 
Policy developed by: Health System Performance 
Approved at Portfolio Executive on: 6 September 2012 
Next review due: 30 September 2018  

 
 

Summary The Specialist Outpatient Services Patient Focussed 
Booking Guideline provides SA Health employees and 
agents involved in the delivery of specialist outpatient 
services a consistent approach to the management of 
patient bookings for specialist outpatient clinic 
appointments. It aims to ensure timely and efficient access 
to services for all patients whilst minimising inefficiencies 
and rework created by cancelled lists and non-attendance 
of patients at a booked specialist outpatient appointment. 

 

 
Keywords 

 

 
Specialist outpatient services, Patient focussed booking, 
Guideline 

 
 

Policy history 

 
 

Is this a new policy? Y 
Does this policy amend or update an existing policy? N 
Does this policy replace an existing policy? N 

 
 

Applies to 

 
 

All SA Health Portfolio 
All Department for Health and Ageing Divisions 
All Local Health Networks 

 
 

Staff impact 

 
 

All Staff, Management, Admin, Students; Volunteers 
All Clinical, Medical, Nursing, Allied Health, Emergency, 
Dental, Mental Health, Pathology, Midwifery 

 
 

PDS reference 

 
 

G0120 
 
 

Version control and change history 
 

Version Date from Date to Amendment 
1.0 06/09/2012 Current Original Version 

    
    
    



 
 
 
 
 

Specialist Outpatient Services 
Patient Focussed Bookings 

 
 

1.          Purpose/Background 
 
 

This Guideline provides SA Health employees and agents involved in the delivery of 
specialist outpatient services a consistent approach to the management of patient 
bookings for specialist outpatient clinic appointments. It aims to ensure timely and 
efficient access to services for all patients whilst minimising inefficiencies and rework 
created by cancelled lists and non-attendance of patients at a booked specialist 
outpatient appointment. 

 
 

Ensuring timely and equitable access to care underpins public specialist outpatient 
clinics in South Australia.  Local Health Networks are encouraged to implement 
strategies to manage demand and improve capacity of specialist outpatient clinics 
under the four key principles of patient focussed booking: 

  Making patient appointments no more than 4   6 weeks in advance 
  Establishing an intention to attend before making appointment 
  Ensuring appointment times are staggered and accurately reflect consultation 

time 
  Communicating  directly  with  the  patient  or  their  carer/guardian  (where 

appropriate) to negotiate appointments. 
 
 

Patient non-attendance at booked outpatient appointments without prior notification 
adversely affects the service and patient outcomes in the following ways: 

  When  Did Not Attend  (DNA) patient appointments are re-scheduled, their 
appointment takes the slot of another patient who could have attended. This 
contributes to longer waiting times for appointments. 

  There is lost capacity within the clinic. 
  The use of resources to follow up and rebook patient appointments, which 

could have been otherwise utilised. 
 
 

2.          Responsibility 
 
 

This Guideline articulates the rights and responsibilities of: 
  Clinicians,  Administrative,  and  support  staff  who  work  within  specialist 

outpatient services. 
  Patients  or  the  carer/guardian  of  patients  (where  appropriate)  who  are 

referred to specialist outpatient services. 
 
 

Ensuring this Guideline is supported remains the responsibility of all employees 
involved in making the referral, receiving the referral and ensuring ongoing 
management of the referral. 

 
 

Local Health Network (LHN) Chief Executives are responsible for ensuring that 
specialist outpatient services manage referrals consistent with the principles of the 
Specialist Outpatient Services Patient Focussed Booking Guideline 



 
 
 
 
 

3.          Guideline Detail 
 
 

3.1.  Education and Information 
 

Specialist outpatient clinics will inform and educate patients or their carer/guardian 
(where   appropriate)  about   the   importance  of   attending   clinic   appointments. 
Education may include the provision of information about patient responsibilities and 
the effects of missed appointments on service provision. 

 
 

In addition, the following measures should be used to reduce the number of missed 
appointments: 

  Keeping  the  patient  or  their  carer/guardian  (where  appropriate)  and  the 
referring practitioner informed through written and/or verbal communication. 

  Negotiating  appointment  times  and  dates  directly  with  patients  or  their 
carer/guardian (where appropriate), using patient focused booking. 

  Reducing the number of specialist follow-up visits.  Once the episode of care 
has concluded patients are returned to the care of the referring practitioner. 

  Auditing of outpatient booking lists monthly. 
  Ensuring  prompt  contact  with  patients  or  their  carer/guardian  (where 

appropriate) following non-attendance of a specialist clinic. 
 
 

Local Health Networks will implement procedures to identify patients who do not 
attend their specialist outpatient appointment. Written notification of failure to attend 
will be sent to the patient or their carer/guardian (where appropriate) and referrer. 

 
 

Specialist outpatient clinics will ensure that patients are not disadvantaged as a result 
of clinic initiated cancellations. 

 
 

3.2.  New Patients 
 

Patients who are scheduled but have not as yet attended their first specialist 
appointment (New patients) have not commenced their episode of care and as such 
remain the responsibility of the referring practitioner. 

 
 

Failure of New Patients to attend their first specialist outpatient appointment without 
notification will result in the referral and an accompanying letter advising the General 
Practitioner of non-attendance. These patients will be removed from the booking 
queue at the time of initiating the letter. 

 
 

Patients who miss a scheduled appointment should not receive a new appointment 
until their intention to attend has been determined. 

 
 

3.3.  Review Patients 
 

Review Patients are those patients who have attended their first specialist 
appointment, however, have not completed their episode of care. Clinic staff will 
attempt to contact the Review Patients or their carer/guardian (where appropriate) 
who fail to attend an appointment without notification to ascertain the reason for non- 
attendance, establish intention to attend and negotiate a further appointment.  This 
process could be either by phone or a written Patient Focussed Booking process 
requesting the patient or their carer/guardian (where appropriate) contact the clinic. 
Failure to make reasonable contact with the patient or their carer/guardian (where 
appropriate) through any of these means will result in the patient being discharged 
from the appointment system with notification sent to the patient or their 
carer/guardian (where appropriate) and the referrer. 



 
 
 
 
 
 

Review patients who fail to attend on two consecutive occasions without notification 
will be removed from the appointment booking queue.  The patient s referring doctor 
and/or general practitioner will be notified in writing of the removal and will be given 
follow up instructions as per the Active Discharge from Specialist Outpatient Services 
Guideline. 

 
 

There may be circumstances where a patient is at high risk of deterioration or have 
complex health issues that require medical assessment.  In these cases a medical 
review is indicated and follow up may be warranted with their General Practitioner. 

 
 

Please note that in a paediatric setting additional localised process will be required to 
address children who are vulnerable, Aboriginal or under the Guardianship of the 
Minister. 

 
 

3.4.  Roles and Responsibilities 
 

Specialist Outpatient Services will: 
  Ensure every effort has been made to communicate effectively with all patients 

or their carer/guardian (where appropriate), particularly those of a culturally 
and linguistically diverse (CALD) background and vision / hearing impaired. 

  Exercise discretion to avoid disadvantaging patients in the case of genuine 
hardship, misunderstandings and other unavoidable circumstances. 

  Inform and educate patients or their carer/guardian (where appropriate) about 
the effects   of   non-attendance   in   order   to   minimise   occurrence   and 
consequences of missed appointments. 

  Negotiate  appointment  times  and  dates  directly  with  patients  or  their 
carer/guardian (where appropriate). 

  Notify the referrer / GP of the patient s failure to attend and/or their removal 
from the appointment queue. 

  Ensure that high risk patients who DNA are followed up to determine whether 
they intend to attend a further appointment. 

 
 

3.5.  Patient / Carer will: 
 

  Advise the specialist outpatient clinic of any changes to their contact details. 
  Attend appointments provided by the specialist outpatient clinic. 
  Advise the specialist outpatient clinic if they have changed your mind, or need 

to cancel or postpone their appointment. 
  Take responsibility for their health and treatment as outlined in the SA Health 

 Your Rights and Responsibilities  publication. 
 
 

4.          Definitions 
 
 

Appointment Queue: A  register which contains details about patients who are 
waiting for a specialist outpatient clinic appointment. 

 

Clinician: A generic term used to describe a wide range of health professionals 
 

DNA: Did not attend. A patient who does not attend their appointment and fails to 
provide notice of this. 

 

Employee: Is employed by SA Health to perform a job subject to the directions of the 
workplace. Each employee has a contract of employment 



 
 
 
 
 

Episode of Care: A single course of treatment which commences at the first 
consultation, continues through treatment / opinion and concludes when the patient is 
returned to the care of the referring practitioner. 

 

General Practitioner: A medical practitioner who works in primary health care and 
refers patients to specialist medical care. 

 

New Patient: A patient newly referred attending a clinic for the first time for a 
particular condition. 

 

Referral: A request for a specialist consultation for a particular condition. 
 

Review Patient: A patient who has attended their first specialist appointment but 
who has not completed their episode of care. 

 

Specialist: A medical practitioner who has become specialised in a specific area of 
medicine and usually has a private practice. 

 

Specialist outpatient clinic: Specialist outpatient services provided by a specialist 
or expert clinician that is recognised by the relevant professional college, board or 
association. 

 

 
 
 

5.          Associated Directives and/or Guidelines 
 
 

eA523220      Specialist Outpatient Services Directive 
 

eA524282 Referral to Specialist Outpatient Services Guideline 

eA524287 Emergency Department Referrals to Specialist Outpatient 

Services Guideline 

eA524289 Active Discharge from Specialist Outpatient Services Guideline 

eA518245 Medicare Billing for Private Non-admitted Patients in SA Health Local 
Health Network Outpatient Clinics 

 
 

6.          References 
 
 

SA Health: Your Rights and Responsibilities   A Charter for consumers of the South 
Australian Public Health System 


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