Service Lead Input Form – Access Policy

Section 1 — Service Overview

Service name:

Service lead name:

Service lead contact details (email):

Locations/teams covered:

Section 2 — Scope & Dataset

Confirm your service is non‑consultant‑led

Yes No

The Community Health Services (CHS) SitRep is a monthly NHSE return that reports waiting list position across community services, including the number of patients waiting and the proportion waiting over 18 weeks.

Do you report CHS SitRep data for this service?

Yes No

Do you report any waiting time KPIs that differ from CHS SitRep?

Yes No

If Yes – complete KPI table

KPI Name

Measure Type

Target/Timeframe

Commissioning Source

Monitored by

Notes

Section 3 — Referrals & Triage

Which referral routes do you accept? (tick all that apply)

eRS GP Self‑referral A&G Internal Referral Other

Do you have a written triage SOP?

Yes No

Upload triage SOP (optional)

Section 4 – Adding patients to the Waiting List

What triggers a patient being added to your waiting list operationally?

Referral received (date referral is received by the service) Referral accepted following administrative validation Referral accepted following clinical triage Added to waiting list following triage outcome First appointment booked Other (please specify)

Section 6 — PIFU (Patient‑Initiated Follow‑Up)

Does your service use PIFU?

Yes No In development

If yes, which pathways/patient groups?

Any challenges or learning from PIFU implementation?

Section 7 — DNAs / WNB / No Access

Describe your process for first DNA (Adults):

Describe WNB process (CYP, if applicable):

Describe No Access process (domiciliary visits):

Do you record evidence that the appointment was clearly communicated?

Yes No

Upload DNA/WNB/No‑Access SOP (optional)

Section 9 — Data Quality & Reporting

How often do you validate your waiting list?

How often do you review and validate your 18-week wait dashboard?

Top data quality issues in your service:

How confident are you in the quality of your 18-week wait data?

Very confident Mostly confident Some concerns Not confident

If you selected “some concerns” or “not confident,” please explain

Section 10 — Governance, Training & Support Needs

Which governance meetings do you report into?

Any training needs (reasonable offers/WNB/Active Monitoring)?

What support would help most (BI / Digital / Policy clarity)?

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web@ecchcic.nhs.uk