NEARLY 6,800 outpatient appointment slots at Gwent hospitals could be saved every year if non-attendance rates were reduced to the current lowest in Wales across 11 specialties.

And more than 3,200 outpatient referrals a year to the same hospitals could be avoided if referral rates in Gwent were cut, again to the current lowest in Wales.

Aneurin Bevan Health Board is considering ways of revamping the outpatient model of care which has remained unchanged across the NHS for more than 60 years.

Around 450,000 patients will attend at least one of Gwent’s outpatient departments this year and many will return for a follow-up appointment.

A report in the health board’s annual plan says proposals being looked at include improved booking systems, ensuring patients are referred to the most suitable service – for instance, straight to physiotherapy or audiology – as soon as possible where appropriate, and ensuring post-surgery follow- up appointments only take place where there is evidence that this is necessary, rather than as standard.

These measures could help reduce outpatient referral rates, which across 11 specialties including general surgery, orthopaedics, ENT (ear, nose and throat), ophthalmology, paediatrics and gynaecology, are higher per 10,000 population than the lowest in Wales.

There are big differences in some referral rates in Gwent, compared to the lowest in Wales. In orthopaedics there are 22.08 referrals per 10,000 population, compared to the lowest Wales rate of 14.95, and in ophthalmology the Gwent rate is 14.69 per 10,000, compared to a Wales lowest of 8.74.

Similarly, there are some big differences in missed appointment rates in Gwent, compared to other parts of Wales. In ENT, 13.46 per cent of outpatient appointments in Gwent are missed, with the lowest rate in Wales being 7.4 per cent. And in oral surgery the Gwent rate is 13.81 per cent against a lowest rate in Wales of 5.66 per cent.

Streamlining the outpatient system would also be likely to help cut missed appointments, known as DNAs or ‘did not attends’, by making it easier and more flexible for patients, and minimising the need for hospital attendances and the number of such attendances.